UMASS/AMHERST         • 


3iaDt>t.DD5aDHT53 


LIBRARY 


OF  THE 


MASSACHUSETTS 

AGRICULTURAL 

COLLEGE 

SOURCE  n^  Js .  S«:.,.^T.  Prcirofliio?./Wt 
l8S3-nil 


S 

73 

B27 

V.2 


INFECTIOUSNESS  OF  MILK 


RESULT  OF  INVESTIGATIONS  MADE  FOR  THE 

TRUSTEES    OF    THE    MASSACHUSETTS 

SOCIETY  FOR  PROMOTING 

AGRICULTURE 


M/Ji^'  yin^    uO'iJj'^C 


BOSTON 

1895 


Copyright,  1895, 

By  the  MASSACHUSETTS  SOCIETY  FOR  PROMOTING 

AGRICULTURE. 


All  rights  reserved. 


The  Riverside  Press,  Cambridge,  Mass.,  U.  S.  A. 
Electrotyped  and  Printed  by  H.  O.  Houghton  &  Co. 


PREFACE. 


In  the  spring  of  1887  the  trustees  of  the  Massachusetts 
Society  for  Promoting  Agriculture  decided  to  establish  an 
Experiment  Station  at  "  Forest  Hills,"  in  Boston,  to  study 
the  dangers  to  human  life  and  health  arising  from  the  food 
products  of  cattle. 

Attention  had  been  publicly  called  to  this  subject,  and  the 
trustees  decided  that  it  would  be  of  value  to  both  producer 
and  consumer  to  have  those  dangers  investigated. 

They  appointed  a  special  committee  to  have  charge  of  the 
work,  consisting  of  Messrs.  Thomas  Motley,  E.  F.  Bowditch,* 
Jacob  C.  Rogers,  and  Francis  H.  Appleton. 

This  committee  secured  the  services  of  leading  specialists 
to  have  the  direction  of  the  investigations,  and  this  volume 
contains  the  report  of  the  work  done,  and  results  obtained. 

These  results  were  reached  in  the  autumn  of  1890,  and 
were  reported  to  the  Legislature  of  1891,  on  January  13th, 
by  petition  asking  for  legislation  to  secure  an  inspection  pf 
cattle  in  Massachusetts. 

It  was  not  imtil  June  11th  that  a  Resolve  was  passed,  but 
with  an  appropriation  much  less  than  was  recommended,  and 
so  small  as  to  negative  the  purpose  of  the  Resolve. 

*  Deceased. 


THE  MASSACHUSETTS  SOCIETY 

FOR 

PROMOTING  AGRICULTURE. 


TRUSTEES   FOR  1894. 

THOMAS  MOTLEY,  President, 

LEVERETT  SALTONSTALL,  First  Vice-Pbest., 

CHARLES  S.  SARGENT,  {S^XJ^-^«||^^^^^^^ 
FRANCIS  H.  APPLETON,  |  lS£^^  Secretary, 

JACOB  C.  ROGERS,  Treasurer, 
HENRY  SALTONSTALL,* 
HENRY  S.  RUSSELL, 
JOHN  LOWELL, 
AUGUSTUS  HEMENWAY, 
S.  ENDICOTT  PEABODY, 
FRANCIS  SHAW, 
HENRY  S.  HUNNEWELL. 

*  Deceased. 


INFECTIOUSNESS  OF  MILK. 


EEPOET 

OF  WORK  DONE  UNDER  THE  AUSPICES  OF  THE  MAS- 
SACHUSETTS SOCIETY  FOR  PROMOTING  AGRICULTURE, 
UPON  THE  INFECTIOUSNESS  OF  MILK  FROM  TUBER- 
CULOUS COWS  WITH  NO  LESION  OF  THE  UDDER. 

November,  1894. 

To  the  Trustees  of  the  Massachusetts  Society  for  Promoting 
Agriculture :  — 

Gentlemen  :  I  have  the  honor  of  presenting  herewith  the 
report  of  the  work  done  under  your  auspices,  upon  the  ques- 
tion of  the  infectiousness  of  the  milk  from  cows  affected  with 
tuberculosis.  This  report  was  not  completed  immediately 
upon  the  close  of  the  experiments,  for  the  reason  that  the 
committee  of  the  trustees  in  charge  did  not  desire  it,  and  the 
delay  in  its  production  since  I  was  requested  to  write  it  last 
fall  has  been  absolutely  unavoidable. 

My  connection  with  the  work  was,  at  first,  simply  that  of 
an  expert  microscopist ;  but  after  the  first  year  its  entire 
direction  lay  in  my  hands,  with  the  society's  veterinarian. 
Dr.  Austin  Peters,  as  first  assistant.  Much  of  the  actual 
manipulation  was  carried  on  by  him  and  by  Dr.  Henry  Jack- 
son and  Langdon  Frothingham,  D.  V.  M. 

The  desire  of  the  committee  was  to  determine  whether  or 
not  the  milk  derived  from  tuberculous  cows  might  contain 
the  infectious  material  of  the  disease,  and  in  this  way  become 
dangerous  when  used  as  an  article  of  food.  And  this  ques- 
tion was  of  necessity  to  be  divided  into  two  parts:  1st, 
whether  this  infection,  if  it  existed,  was  confined  to  cases  in 
which  there  was  actual  tuberculous  disease  of  the  udder ;  and, 
2d,  whether  it  might  exist  in  cases  in  which  the  udder  was 


2  INFECTIOUSNESS  OF  MILK. 

apparently  or  actually  healthy,  but  the  disease  existed  in 
other  parts  o£  the  body. 

In  regard  to  the  first  part  of  the  question,  plain  common 
sense  showed  that  the  danger  of  infection  was  a  real  one,  and, 
besides  this,  there  existed  at  the  time  sufficient  experimental 
data  to  prove  the  fact,  so  that  there  was  very  little  dispute 
that,  under  such  circumstances,  milk  should  not  be  used  for 
food,  —  certainly  in  an  uncooked  condition.  Evidence  since 
then  in  the  same  direction  has  constantly  accumulated,  and 
now  there  is  hardly  a  dissenting  opinion  that  milk  from  cows 
with  tuberculosis  of  the  udder  should  be  condemned  for  food. 

Upon  the  second  point,  however,  as  to  whether  the  milk 
from  cows  with  tuberculosis,  but  not  of  the  udder,  might  be 
dangerous,  there  was  a  great  diversity  of  opinion,  and  almost 
no  experimental  evidence  upon  which  to  base  what  opinion 
there  was.  It  was  in  this  direction,  therefore,  that  it  was 
especially  desirable  to  obtain  evidence,  and,  after  considerable 
discussion,  it  was  decided  that  the  main  line  of  experiment 
should  be  so  conducted  that  this  point  might  be  decided.  In 
this,  as  in  everything  else,  it  is  to  be  remembered  that  one 
piece  of  positive  evidence  obtained  under  proper  conditions  is 
worth  many  negative  results,  and  it  is  for  this  reason  that  so 
much  value  may  be  attached  to  the  results  which  have  been 
obtained.  These  were  published  in  an  incomplete  form,  and 
have  been  very  widely  disseminated,  having  appeared  in  full 
in  the  "Transactions  of  the  Association  of  American  Physi- 
cians," "The  American  Journal  of  the  Medical  Sciences," 
"  The  Practitioner,"  "  The  New  Hampshire  State  Board  of 
Health  Keport,"  "  The  Bulletin  of  the  Agricultural  Experi- 
ment Station,"  "  Transactions  of  the  Congr^s  sur  la  Tuber- 
culose,"  the  "  Centralblatt  fiir  Bakteriologie,"  besides  having 
been  largely  quoted  in  many  other  ways.  It  is  unquestion- 
able that  they  have  had  much  influence  in  moulding  public 
opinion  in  this  matter,  and  at  least  one  direct  result  of  the 
work  has  been  the  inspection  of  the  herds  of  cattle  in  New 
York  by  the  board  of  health  of  that  state. 

The  work,  then,  was  undertaken  with  this  special  end  in 


INFECTIOUSNESS   OF  MILK.  3 

view,  to  determine  whether  the  infectious  element  of  tubercu- 
losis ever  existed  in  milk  from  tuberculous  cows  whose 
udders  were  apparently  healthy,  and  was  prosecuted  under 
the  following  headings :  1.  A  careful  and  persistent  micro- 
scopic examination  of  the  milk  from  such  cattle ;  2.  Inocu- 
lation experiments  with  such  milk;  3.  Feeding  experiments 
with  the  same  milk.  In  addition  to  these  three  main  lines 
of  investigation,  there  was  also  undertaken :  4.  Similar  in- 
vestigations of  the  milk  supply  of  Boston ;  and,  5.  The  gath- 
ering of  as  much  evidence  as  possible  from,  medical  men 
and  veterinarians  as  to  cases  of  probable  infection  through 
tuberculous  milk  that  had  come  under  their  observation. 

The  methods  by  which  these  points  were  observed  and  the 
results  that  were  obtained  are  given  below.  The  experi- 
mental farm,  where  the  animals  were  kept,  was  at  Mattapan, 
where  it  was  possible  to  obtain  the  best  hygienic  conditions, 
and  where  the  feeding  experiments  and  post-mortem  examina- 
tions were  conducted,  while  the  remainder  of  the  work  was 
done  at  the  bacteriological  laboratory  of  the  Harvard  Medical 

School. 

I. 

Cover-glass  examinations  of  milk  from  coivs  affected  with 
tuberculosis,  but,  so  far  as  the  best  veterinary  examination 
could  determine,  with  no  disease  of  the  udder. 
These  examinations  were  made  methodically  and  continu- 
ously for  over  two  years.  The  milk  was  collected  in  ster- 
ilized flasks,  after  the  udder  had  been  cleansed  as  perfectly 
as  possible,  and  the  hands  of  the  operator  sterilized.  It  was 
taken  at  once  to  the  laboratory  and  allowed  to  stand,  care- 
fully protected,  over  night,  and  sometimes  longer.  Different 
portions  were  then  taken  for  examination  from  both  the 
bottom  and  the  top  of  the  fluid.  In  all  cases  at  least  a  dozen 
cover-glasses  were  used  for  each  examination,  and  at  least 
fifteen  minutes  was  spent  over  each  cover-glass.  The  stain- 
ing employed  was  invariably  the  Koch-Ehrlich  24-hour 
method. 

The  results  of  this  line  of  investigation  are  given  below  in 


[  INFECTIOUSNESS   OF  MILK. 

TABLE  1. 
EXAMINATIONS  OF  MILK  FOR  BACILLI  OF  TUBERCULOSIS. 


Number  and 
Source. 

Date. 

Symptoms  and  phys- 
ical signs  of  cow. 

Result. 

Post-mortem,  if  any  made. 

1 

1887 

Dutton 

Dec.  14 

T.  =  103.5. 

Neg. 

Butcher's  autopsy  =  Tu- 

cow. 

Emaciation.  No 
signs  in  udder. 

berculosis  of  both  lungs, 
pleurae,      pericardium, 

2 

and  mediastinum. 

J.  C.  R. 

Dec.  17 

Healthy  in  May- 
Dec  =  +  d 
lymphatics. 
Dull  and— d 
resps.  on  r.  side 

(( 

None. 

3 

cough. 

J.  C.  R. 

« 

Healthy  in  May- 
Dec.  =  +  d  sub- 
maxillary 

(( 

u 

4 

glands. 

J.  C.  R. 

(( 

Ibid.  duU  1. 

(( 

U 

5 

lung. 

J.  C.  R. 

6 
J.  C.  R. 

7 
J.  C.  R. 

8 
J.  C.  R. 

9 
F.  L.  A. 

K 

Ibid,  as  3. 

<( 

(( 

(( 

Ibid. 

u 

(( 

U 

Ibid. 

(( 

(( 

Ibid. 

(( 

« 

Dec.  14 

Pes. 

Dr.  Peters,  Dec.  22.    Tu- 

bereulosLs  of  lungs,  pleu- 

ra,   liver,   spleen,    peri- 

toneum,    ovaries,     and 

mediastinum.        Udder 

10 

1888 

healthy. 

J.  C.  R. 

Jan.  1 

No  rec- 

None. 

11 

ord. 

J.  C.  R. 

(( 

(( 

« 

12 

1887 

Mrs.  B. 

Dec.  22 

+  d  sub-maxil- 
lary glands. 
Dull  on  r.  side. 

Neg. 

(C 

13 

1888 

Udder  healthy. 

McLean 

Jan.  23 

Cough  at  times. 

Milk  spoiled  and  ex.  not 

Asylum. 

Udder  indura- 

completed. 

14 

ted. 

McLean 

K 

(( 

Asylum. 

15 

McLean 

« 

(( 

Asylum. 

16 

H.  A.  D. 

Feb.  8 

Cough.    Rough 
I'esp.  over  r. 
lung.     Posterior 
quarters  of  ud- 
der indurated. 

Neg. 

None. 

INFECTIOUSNESS  OF  MILK. 
Table  L  (^continued). 


Number  and 
Source. 

Date. 

Symptoms  and  phys- 
ical signs  of  cow. 

Result. 

Post-mortem,  if  any  made. 

17 

Cow  A. 

Feb.  18 

Sub-max.  glands 
+  d.     Nodu- 
lated  post,  half 
udder.    General 
appearance 
good.  Milk  from 

Pos. 

Jan.   9,   1889.     R.  lung 
slightly  tuberculous.   + 
d  inguinal  gland.     Ud- 
der =  no  tuberculosis. 
Lung  showed  bacilli. 

18 

post,  udder. 

Cow  A. 

March  10 

Milk  from  1.  hind 

Neg. 

«                           M 

19 

teat. 

Cow  A. 

20 
Cow  A. 

Jnne  2 

Morning's  milk. 

K 

«                « 

Nov.  8 

((             <( 

(( 

«                « 

21 

CowB. 

Feb.  29 

8-10  yrs.     Pul- 
monary tub.  and 
probably  else- 
where.    Ema- 
ciation and 
cough.    Udder 
healthy. 

(( 

July  6,  1889.      Gen.  tu- 
berculosis     of      lungs, 
pleura,   liver,    peritone- 
um, spleen,  ovaries,  ute- 
rus, and  glands.     Udder 
scirrhous,  but  no  tuber- 
culosis.     Sections  from 

22 

lung  showed  bacilli. 

CowB. 

March  10 

(( 

« 

Sections      from       udder 

23 

showed  no    bacilli 

CowB. 
24 

Aprils 

<( 

<( 

CowB. 

March  25 

(( 

i(              « 

25 

CowB. 

June  1, 

(( 

K                           (( 

26 

eve. 

CowB. 

June  2, 

(( 

((               « 

27 

morn. 

CowC. 

Feb.  29 

R.  post,  quarter, 
of  udder  nodu- 
lated.  No  other 

i( 

None. 

28 

symptom. 

CowC. 

March  10 

(( 

<( 

29 

CowE. 

March  28 

-|-  d  sub-max. 
glands.     DuU 
and  rales  lower 
r.  lung.    Little 
cough. 

(( 

June  21,  1890.     Ant.  r. 
lobe  tuberculous  mass; 
abscesses     upper     post, 
lobe  both  lungs.   Bacilli 
present.   Udder  few  nod- 
ules r.  post,  quai-ter.  No 

30 

bacilli. 

CowE. 

Nov.  8, 
mom. 

(( 

u                      U 

INFECTIOUSNESS  OE  MILK. 
Table  I.  (continued). 


Number  and 
Source. 

Date. 

Symptoms  and  phys- 
ical signs  of  cow. 

Result. 

Post-mortem,  if  any  made. 

31 

CowH. 

March  28 

+  STib-max. 
glands.    Proba- 
ble disease  of 
both  lungs.     L. 
post,  quarter  ud- 
der nodulated. 

(( 

April  10,  1889.  Few  tu- 
bercles 1.  lung,  few  -|-  d 
and  cheesy  glands  in 
mesentery.  Few  small 
tubercles  in  walls  of 
small  intestine.  Udder 
slightly  fibrous.  Bacilli 
in  lungs  and  gland.    Not 

32 

in  udder. 

CowH. 

Nov.  8 

(( 

33 

CowD. 

AprU  10 

-f  d  sub-max. 
glands.     Prob- 
ably pleuritic 
friction  lower  r. 
lung. 

<( 

Nov.  21, 1889.  +  d  ing. 
gland.  No  bacilli. 
Cheesy  nodule  in  liver, 
abscesses  in  both  lungs 
show  bacilli.     Udder 

34 

scirrhous.    No  bacillL 

CowD. 

35 
CowD, 

Nov.  8 

Pos. 

((                 (( 

Dec.  11 

From  nodulated 

Neg. 

<(                (( 

36 

teat. 

Slocmn. 

April  19 

Probable  general 

(( 

None. 

37 

tubere. 

CowG. 

April  20 

-f-  d  sub-max. 
glands.  Cough. 
Dull  and  crep. 
lower  r.  lung. 

<( 

March  4,  1890.  Tuber- 
culosis of  lungs  and  -f-  d 
glands  above  udder.  Ba- 
cUli    in    both.      Udder 

38 

healthy. 

CowG. 

Nov.  8 

« 

U                                (( 

39 

CowF. 

t( 

Ibid.     Coughs, 
much. 

(( 

August  21,  1889.  KUled. 
Tuberculosis  both  Ivmgs, 
liver,  omentum,  small  in- 
testine. Udder  showed 
one    quarter    scirrhous. 

40 

No  bacilli. 

Cowl. 

(( 

-f  d  sub-max. 
glands.    Dull 
over  both  lungs. 
Crepitus  on  r. 
side.    Cough. 

Pos. 

March  4,  1890.  General 
condition  improved. 
Limgs  almost  healthy. 
Nodules  in  liver  =  ba- 
cilli. +  d  glands  above 
udder.     Udder  slightly 

41 

scirrhous.     No  bacilli. 

Cow  J. 

(( 

-f-  sub-max. 
glands.    Both 
lungs  involved. 
Cough. 

K 

Jan.  9,  1889.  Killed. 
Tuberculosis  of  r.  lung, 
liver,  and  mediastinal 
gland.  Bacilli  in  all. 
Echinococci  in  liver. 

INFECTIOUSNESS   OF  MILK. 
Table   I.  (continued). 


Number  and 
Source. 

Date. 

Symptoms  and  phys- 
ical signs  of  cow. 

Result. 

Post-mortem,  if  any  made. 

42 

"Brownie." 

Nov.  26 

Pos. 

By  J.  F.  Winchester,    -f 
d      lymphatic      glands. 
Lungs  generally  tuber- 
culous,  pleura,    mesen- 
tery, and  ovaries.  Udder 
^  scirrhous  but  not  tu- 

43 

berculous. 

J.  F.  W. 

Nov.  26 

Neg. 

By  J.  F.  W.     Lungs  me- 
diastinal   and    external 
lymphatics  tuberculous. 

44 

Other  parts  healthy. 

CowD. 

Jan.  11 

First  of  milking. 

« 

Vide  supra,  33. 

45 

CowD. 

Jan.  11 

TiAst  of  Tnilfein^. 

« 

(         u 

46 

CowE. 

Jan. 16 

First  of  miUdng-. 

« 

'     29. 

47 

CowE. 

Jan.  16 

Last  of  milking. 

« 

(      (( 

48 

1889 

CowF. 

49 
CowF. 

50 
CowG. 

51 
CowG. 

52 
CowH. 

53 
CowH. 

Jan.  18 

First  of  milking. 

« 

'     39. 

(( 

Last  of  milking. 

(( 

<      <( 

Jan.  20 

First  of  milking. 

u 

'     87. 

(( 

Last  of  milking. 

u 

I     « 

Jan.  26 

First  of  milking. 

il 

'     31. 

« 

Last  of  milking. 

u 

(      « 

54 

Cowl. 

55 
Cowl. 

Jan.  30 

First  of  milking. 

u 

'     40. 

« 

Last  of  milking. 

(( 

(      (( 

56 

CowM. 

Feb.  2 

First  of  milking, 

(( 

57 

sediment. 

CowM. 

(( 

Last  of  milking, 

(( 

58 

sediment. 

CowL. 

March  5 

First,  of  miHring. 

(( 

June    25,  1890.      Large 
cheesy  masses  in  lungs 
^  Bacilli.    Liver  medi- 
astinal and  ing.  glands- 

59 

Udder  healthy. 

CowL. 

60 

(( 

Last  of  milking. 

(( 

«                 « 

CowO. 

March  6 

First  of  milking, 
cream. 

Pos. 

August  21, 1889.    Killed. 
Limgs,  liver.  Ing.  glands 
above   udder  ^   +    d. 
Udder   healthy,   except 
scirrhous  in  1.  post,  quar- 

ter 

N 

0  bacilli. 

INFECTIOUSNESS   OF  MILK. 
Table  I.  (continued). 


Number  and 
Source. 

Date. 

Symptoms  and  phys- 
ical signs  of  cow. 

Result. 

Post-mortem,  if  any  made. 

61 

CowO. 

March  6 

First  of  milking, 
sediment. 

Neg. 

August  21,  1889.  Killed. 
Lungs,  liver.  Ing.  glands 
above  udder  =  +  d. 
Udder  healthy,  except 
scirrhous  in  1.  post,  quar- 

62 

ter.     No  bacilli. 

CowO. 

(( 

Tjaflt  of  milking, 

II 

II                  11 

63 

cream. 

CowO. 

(1 

Last  of  milking. 

Pos. 

11                  II 

64 

sediment. 

Cow  P. 

II 

Cream  before 
death. 

it 

March  6,  1889.  Killed. 
Whole  thoracic  cavity 
and  diaphragm,  mesen- 
tery tuberculous.  Liver, 
ing.  gland  +  d.    Bacilli. 

65 

Udder  healthy. 

Cow  P. 

K 

Sediment  before 

Neg. 

11                  11 

66 

death. 

Cow  P. 

(1 

Cream  after 

Pos. 

li                  11 

67 

death. 

Cow  P. 

II 

Sediment  after 

II 

II                  (( 

68 

death. 

CowD. 

March  11 

First  of  milking, 

II 

Vide  35. 

69 

cream. 

CowD. 

>( 

First  of  milking. 

Neg. 

II 

70 

sediment. 

CowD. 

11 

Last  of  milking. 

II 

II 

71 

cream. 

CowD. 

(1 

Last  of  milking. 

Pos. 

K 

72 

sediment. 

CowE. 

March  14 

First  of  milking. 

Neg. 

73 

cream. 

CowE. 

(1 

First  of  nwlking. 

II 

74 

sediment. 

CowE. 

K 

Last  of  milking. 

i< 

75 

cream. 

CowE. 

(1 

Last  of  milking. 

Pos. 

76 

sediment. 

Cow  P. 

March  18 

First  of  milking. 

Neg. 

77 

cream. 

CowF. 

II 

Last  of  milking, 

II 

78 

cream. 

CowG. 

March  20 

First  of  milking. 

t( 

79 

cream. 

CowQ. 

(( 

Last  of  milking, 

II 

80 

cream. 

CowH. 

March  23 

First  of  milking. 

<i 

81 

cream. 

CowH. 

II 

Last  of  milking, 

It 

82 

cream. 

Cowl. 

March  28 

First  of  milking, 
cream. 

Pos. 

INFECTIOUSNESS  OF  MILK. 
Table  L  (continued). 


Number  and 
Source. 

Date. 

Symptoms  and  phys- 
ical signs  of  cow. 

Result. 

Post-mortem,  if  any  made. 

83 

Cowl. 

Mai-ch  28 

Last  of  milking, 

Neg. 

84 

cream. 

CowO. 

March  30 

First  of  milking. 

« 

85 

cream. 

CowO. 

u 

Last  of  milking. 

(I 

86 

cream. 

CowM. 

April  4 

First  of  milking. 

II 

June  25,  1890.     Nodules 
all  over  the  skin  =^  Lu- 

87 

pus  ?    Bacilli  present. 

CowM. 

(( 

Last  of  milking. 

(1 

88 

CowQ. 

May  9 

1^ 

Cough 

<i 

August  21,  1889.     Both 

more  or  less 

lungs  and  liver,      -j-  d 

C4H     ^  . 

for  a  year. 

ing.      gland.         Udder 

o  a 

Probable 

healthy. 

.1" 

Em 

general  tu- 

89 

^  berculosis. 

CowQ. 

(1 

<*i  bo 

o  a 

esra 

'  Breathing 
rapid,  poor 

« 

in  flesh,  -|- 

^  a 

d  =  ing. 

90 

, 

glands,  and 

Slocmn. 

June  8 

as 

Mamma- 
ries  1. 
post,  quar- 
ter of 

.    (( 

91 

fe*" 

udder. 

Slocmn. 

« 

First  of  milking, 

Pos. 

92 

cream. 

Slocnm. 

(i 

liast  of  milking. 

Neg. 

93 

sediment. 

Slocmn. 

(( 

Last  of  milking. 

Pos. 

94 

cream. 

Samideis. 

June  11 

Cough  at 
times,  but 

Neg. 

general 

a     -  ^ 

health 

seems 

95 

good. 

Saunders. 

t( 

First  of  milking, 

i( 

96 

cream. 

Saunders. 

« 

Last  of  milking. 

(( 

97 

sediment. 

Saunders. 

II 

Last  of  milking) 

<( 

98 

cream. 

Mayhew. 

June  18 

Emaciated, 
cough,  +  d 
glands  in 
flanks  Sedi- 
iment.     Udder 

(i 

99 

healthy. 

Mayhew. 

<( 

Crea 

m. 

Pos. 

10 


INFECTIOUSNESS   OF  MILK. 
Table  I.  (continued). 


Number  and 

Date. 

Symptoms  and  phys- 

Result. 

Post-mortem,  if  any  made. 

Source. 

ical  signs  of  cow. 

100 

Slocum. 

June  24 

Sediment. 

? 

101 

Slocum. 

i( 

Cream. 

? 

102 
CowK. 

July  10 

First  of  milking, 
sediment. 

Neg. 

August  21.  Killed.  Tu- 
berculous deposits  in 
both  lungs,  spleen,  liver. 
Foetal  membranes  and 
umbilical  cord  also 
(about  4  months).    Ba- 

103 

cilli. 

CowK. 

(( 

First  of  milking, 

Pos. 

104 

cream. 

CowD. 

July  13 

First  of  milking. 

Neg. 

105 

sediment. 

Cow  D. 

(( 

Last  of  milking, 

(( 

106 

cream. 

CowE. 

July  19 

First  of  milking. 

(( 

107 

sediment. 

CowE. 

(( 

Last  of  milking. 

« 

108 

cream. 

CowG. 

July  23 

First  of  milking. 

(( 

109 

sediment. 

CowG. 

u 

Last  of  milking, 

(( 

110 

cream. 

CowF. 

July  25 

First  of  milking, 

(( 

Ill 

sediment. 

CowF. 

<( 

Last  of  milking, 

u 

112 

cream. 

CowF. 

(( 

First  of  milking. 

« 

113 

cream. 

CowF. 

(C 

Last  of  milking, 

l( 

114 

sediment. 

CowL. 

« 

First  of  milking. 

(( 

115 

secliment. 

CowL. 

(( 

First  of  milking, 

« 

116 

cream. 

CowL. 

(1 

Last  of  milking, 

(( 

117 

sediment. 

Cow  L. 

(( 

T.nst.  nf  milking, 

(( 

118 

cream. 

J.  F.  W. 

August  23 

Milk. 

(( 

Cow  at  Lawrence.  Ud- 
der said  to  be  tubercu- 
lous.     Attempt  at  au- 

119 

topsy  failed. 

J.  F.  W. 

Cream. 

P03. 

120 

Sept.  5 

Milk. 

No  rec- 
ord. 

121 

(( 

Cream. 

INFECTIOUSNESS   OF  MILK.  H 

A  summary  of  what  is  shown  here  is  as  follows :  — 

There  were  121  examinations  of  milk  and  cream  made,  the 
specimens  coming  from  thirty-six  different  animals.  The 
bacilli  of  tuberculosis  were  found  in  one  or  more  cover- 
glasses  upon  nineteen  different  occasions. 

These  nineteen  positive  results  were  obtained  from  twelve 
different  animals,  and  the  bacilli  were  found  in  about  equal 
proportion  in  the  milk  and  the  cream ;  they  were  seen  more 
than  once  in  milk  from  the  same  cow,  at  different  examina- 
tions, six  times. 

The  bacilli  were  actually  seen,  therefore,  in  specimens  from 
one  third  (33^)  of  the  animals  examined. 

That  these  animals  were  actually  affected  with  tuberculosis, 
and  that  the  udder  was  free  from  disease,  was  proven  in  all 
possible  cases  by  careful  post-mortem  examinations.  These 
were  conducted  upon  twenty  out  of  the  thirty-six  animals 
shown  in  Table  I.  and  the  notes  of  that  examination  are 
given  in  the  last  column  of  that  table. 

n. 

INOCULATION  EXPERIMENTS  UPON  ANIMALS. 

These  experiments  were  conducted  under  as  careful  pre- 
cautions as  could  be  devised.  The  animals  (guinea-pigs  and 
rabbits)  were  carefully  selected  in  the  first  place,  and  kept 
under  observation  for  some  time.  Any  but  those  apparently 
perfectly  healthy  were  rejected,  and  both  before  and  during 
the  experiments  they  were  all  kept  under  as  perfect  hygienic 
conditions  as  could  be  secured. 

The  milk  and  cream  used  for  inoculation  was  obtained  with 
the  same  precautions  as  was  that  for  the  microscopic  exami- 
nations, was  invariably  injected  subcutaneously,  and  always, 
of  course,  with  a  sterilized  and  fresh  syringe  for  each  case. 
The  animals  were  kept  under  observation  for  at  least  six 
weeks,  and  were  then  subjected  to  exceedingly  careful  post- 
mortem examination. 


12 


INFECTIOUSNESS   OP  MILK. 


The  results  of  this  work  are  exhibited  in  Tables  11.  (inocu- 
lation experiments  upon  guinea-pigs)  and  III.  (inoculation 
experiments  upon  rabbits). 


TABLE  n. 

lUOCtTIiATION     OF    GumEA     PiGS. 
(All  Inoculations  subcutaneous.) 


1 

Date  of 
Inocula- 
tion. 

Material 

used,  and 

Source. 

Quan- 
tity 
used. 

Date 
Killed. 

Time 
Elapsed. 

Result. 

1889 

1889 

1 

Jan.  15 

1  of  m. 
CowD. 

8  CO. 

Mch.  1 

44  d. 

Negative. 

2 

« 

L.  of  m. 
CowD. 

7  CO. 

(( 

« 

« 

3 

i( 

a 

4  c.c. 

K 

i( 

u 

4 

Jan.  19 

L.  of  m. 
CowE. 

(( 

(( 

40  d. 

Negative.  Pin-head  whitish 
nodules  in  liver;  non- 
tuberculous. 

5 

(( 

1  of  m. 
CowE. 

<c 

(C 

<( 

Negative. 

6 

(( 

(( 

(C 

(( 

li 

(( 

7 

Jan.  22 

1  of  m. 

CowF. 

3  c.c. 

Mch.  11 

48  d. 

Negative.  Punctate  hemor- 
rhage in  lungs ;  otherwise 
normal. 

8 

« 

L.  of  m. 
CowF. 

(( 

(( 

« 

(1                (( 

9 

(( 

it 

1  c.  c. 

(( 

(( 

((                (1 

10 

Jan.  26 

1  of  m. 
CowG. 

3c.c. 

Jan.  30 
Died 

4d. 

Negative.  Acute  peritoni- 
tis ;  plates  sterile  ;  cover- 
glasses  showed  nothing. 

11 

<( 

L.  of  m. 
CowG. 

5  c.c. 

Jan.  28 
Died 

2d. 

Negative.  Pleurisy  and  lo- 
bar pneumonia.  A  pig  in 
same  pen  died  of  pneu- 
monia on  Jan.  24;  cul- 
tures sterile. 

12 

(( 

u 

(( 

Mch.  12 

45  d. 

Negative.     Pregnant. 

13 

Jan.  29 

1  of  m. 
CowH. 

4  c.c. 

Mch.  21 

51  d. 

Negative.  Supra-renal  cap- 
sules apparently  enlarged, 
but  negative  under  the 
microscope. 

14 

(( 

L.  of  m. 
CowH. 

10  c.  c. 

(( 

(( 

Negative. 

15 

(( 

(( 

(( 

(( 

(( 

« 

16 

Feb.  2 

L.  of  m. 
Cowl. 

3  c.c. 

Mch.  28 

54  d. 

(( 

17 

(( 

1  of  m. 
Cowl. 

4  c.  c. 

(( 

u 

(( 

18 

(( 

a 

4  c.c. 

(( 

u 

(( 

19 

Feb.  5 

L.  of  m. 
CowM. 

2  c.c. 

Aprils 

57  d. 

(( 

20 

t( 

(( 

(( 

K 

(( 

« 

21 

({ 

(( 

i( 

<( 

(( 

(( 

INFECTIOUSNESS  OF  MILK. 

Table  II.  (continued). 


13 


1 

Date  of 
Inocula- 
tion. 

Material 

used,  and 

Source. 

Quan- 
tity 
used. 

Date 
Killed. 

Time 
Elapsed. 

Result. 

22 

Mch.  5. 

L.  of  m. 
CowL. 

3c.  c. 

May  2 

58  d. 

Negative. 

23 

i( 

1  of  m. 
CowL. 

4  c.  c. 

II 

II 

II 

24 

Mch.  9 

Cream, 
Cow  P. 
before 
death 

II 

Mch.  18 
Died 

9d. 

Positive,  Cheesy  mass  at 
point  of  inoculation  ; 
spleen  and  middle  lobe  of 
r.  lung  congested.  Bacilli 
in  cover-glasses  and  sec- 
tions. 

25 

K 

Cream, 
Cow  P. 

after 
death 

5  c.c. 

May  6 

58  d. 

Positive.  Miliary  nodules 
in  liver  and  spleen  con- 
taining bacilli. 

26 

tl 

11 

II 

II 

II 

Positive.  Many  miliary 
nodules  in  liver  and  spleen 
containing  bacilli. 

27 

(( 

1  of  m. 
Cream, 
CowO. 

4  c.c. 

Mch.  19 
Died. 

13  d. 

Positive.  Lungs  and  me- 
diastinal glands  and  su- 
pra-renal capsule;  bacilli 
in  all. 

28 

(( 

L.  of  m. 
Cream, 
CowO. 

2  c.c. 

May  6 

58  d. 

Positive.  Miliary  nodules 
in  liver  and  spleen ;  bacilli 
in  both. 

29 

11 

II 

II 

II 

11 

Negative. 

30 

Mch.  18 

L.  of  m. 

Cream, 
CowE. 

1  c.c. 

May  21 

64  d. 

Negative.  Spleen  enlarged. 
Negative  under  micro- 
scope. 

31 

(( 

1  of  m. 
CowE 
(sour) 

II 

11 

11 

Negative. 

32 

« 

Cow  E. 
(sour) 

II 

11 

11 

i( 

33 

li 

1  of  mi. 
Cream, 
CowD. 

2  c.  c. 

II 

II 

II 

34 

« 

L.  of  m. 
Cream, 
CowD. 

11 

11 

II 

11 

35 

u 

II 

1  c.  c. 

II 

II 

It 

36 

Mch.  19 

L.  of  m. 
Cream, 
CowF. 

0.6  c.c. 

May  31 

73  d. 

" 

37 

(1 

1  of  m. 
Cream, 
CowF. 

1  c.c. 

11 

II 

Positive.  Liver  and  spleen. 
Bacilli  in  cover  -  glasses 
and  sections. 

38 

11 

(1 

II 

11 

Negative. 

39 

Mch.  23 

1  of  m. 
CowG. 
(sour) 

II 

June  5 

43  d. 

(1 

40 

II 

11 

(1 

II 

11 

(( 

41 

II 

i< 

<i 

II 

11 

U 

14 


INFECTIOUSNESS  OF  MILK. 
Table  IL  (continued). 


1 

Date  of 
Inocula- 
tion. 

42 

Mch.  26 

43 

44 

45 

Mch.  30 

46 

(( 

47 

« 

48 

April  2 

49 
50 
51 

52 

u 

53 
54 

55 


56 
57 


58 
59 


60 
61 


62 
63 


64 


Material 

used,  and 

Source. 


May  11 


June  10 


Jane  14 


June  21 


Quan- 
tity 
used. 


Date 
Killed. 


1  of  m. 

CowH. 

(sour) 


L.  of  m. 

Cowl. 

Cream 

1  of  m. 

Cream, 

Cowl. 


1  of  m. 
Cream, 
CowO. 


L.  of  m. 
Cream, 
CowO. 


L.  of  m. 
Cream, 
Cow  L. 
1  of  m. 
Cream, 
Cow  L. 
(sour) 

a 

Slocum, 
1  hr.  to  u. 
m.  milk. 


Sannders 
sed. 


L.  of  m, 
Mayhew 

L.  of  m. 
Cream, 
Mayhew 


0.5  c.c, 

1  0.  c. 

II 

0.5  c.c, 
1  c.c. 


June  6 


April  23 
(Died) 
June  6 


AprUS 
(Died) 
June  6 


July  2 


Aug.  1 


Aug.  3 


Aug.  8 


Time 
Elapsed. 


41  d. 

28  d. 
41  d. 


9d. 
65  d. 


52  d. 


50  d. 


48  d. 


Result. 


Negative. 

n 

Negative.    Marasmus. 
« 

Negative.    Marasmus. 

Negative. 
Negative. 


Positive.    Liver.    Bacilli  in 
cover-glasses  and  sections. 
Negative. 


Negative.  Many  small  no- 
dules in  spleen;  few  iu 
liver ;  not  tuberculous. 

Negative. 

Positive.  Enlarged  glands 
in  flank ;  nodules  in  spleen 
and  liver ;  bacilli  in  gland. 

Positive.  Spleen  enlarged 
and  granular ;  bacilli. 

Negative.  Spleen  enlarged 
and  granular;  no  bacilli 
found. 

"  " 

Positive.  Spleen  enlarged 
and  granular ;  nodules  in 
liver ;  bacilli  in  spleen. 

Positive.  Spleen  enlarged 
and  granular ;  enlarged 
gland  in  flank ;  bacilli  in 
gland. 


INFECTIOUSNESS   OF  MILK. 
Table  IL  (continued). 


15 


Date  of 
Inocula- 
tion. 


Material 

used,  and 

Source. 


Jnne  21 


June  25 


July  12 


July  16 


July  19 


July  25 


July  27 


L.  of  m. 

Cream, 

Mayhew 

Morning, 
Slocum 

Cream, 
Slocum 
1  of  m. 
CowR. 


L.  of  m. 
Cream, 
CowR. 
1  of  m. 
CowD. 
L.  of  m. 
Cream, 

CowD. 

(( 

1  of  m. 
CowE. 
L.  of  m. 
Cream, 
CowE. 

1  of  m. 
CowG. 
L.  of  m. 
Cream, 
CowG. 

K 

1  of  m. 
Cream, 
CowF. 
L.  of  m. 


Quan- 
tity 
used. 


1  C.  C. 


Cream, 

CowF. 

(( 

(1 

July  30 

1  of  m. 

Cream, 

K 

CowL. 

t( 

1  of  m. 

Beckett 

Sept.  9. 

L.  of  m. 

Cream, 

Beckett 

i( 

(( 

4  c.  c. 


5  CO. 


Date 
Killed. 

Time 
Elapsed. 

Aug.  8 

48  d. 

Nov.  3 

131  d. 

(( 

u 

(( 

(( 

(t 

114  d. 

(( 

« 

(( 

(( 

Nov.  6 

113  d. 

(( 

« 

(( 

(( 

110  d. 

(( 

(( 

« 

(( 

Nov.  11 

109  d. 

« 

(( 

ti 

« 

Nov.  5 

101  d. 

(( 

(( 

t( 

u 

(( 

u 

Nov.  11 


104  d. 
63  d. 


Result. 


Positive.  Spleen  enlarged 
and  granular ;  enlarged 
gland  in  flank ;  bacilli  in 
gland. 

Negative. 


Negative.  Two  nodules  in 
ant.  surface  liver ;  exami- 
nation negative. 

a 

Negative.  Nodules  in  liver ; 
fibromata. 


Negative. 


Missing. 
Negative. 


16 


INFECTIOUSNESS   OF  MILK. 


From  this  table  it  appears  tliat  there  were  88  guinea-pigs 
inoculated  with  milk  from  15  different  cows;  that  tubercu- 
losis was  found  in  12,  and  that  these  results  came  after  the 
use  of  milk  or  cream  from  six  different  animals,  as  follows : 


No. 

Source. 

Material  used. 

Results  found  in 

24 

Cow  P. 

Milk  before  death. 

Lung. 

25 

(( 

Cream  after  death. 

Liver  and  spleen. 

26 

(( 

Cream  after  death. 

L.  and  s.  and  renal  capsules. 

27 

CowO. 

Cream. 

Glands  and  lung. 

28 

« 

Cream. 

Liver  and  spleen. 

37 

CowF. 

Cream. 

Liver  and  spleen. 

53 

CowO. 

Cream. 

Liver. 

59 

Slocum. 

MUk. 

Gland. 

60 

Saunders*. 

Milk. 

Spleen. 

63 

Mayhew. 

Milk. 

Spleen. 

64 

" 

Cream. 

Gland. 

65 

ti 

Cream. 

Gland. 

TABLE  in. 

iKOCUIiATIONS  OF  EaBBITS. 

(All  inocnlatioiis  subcutaneous.) 

Note.  —  L.ofm.  means  that  the  specimen  of  milk  was  taken  at  the  end  of 
milking  ]  \  of  m.  means  that  it  was  taken  when  the  milking  was  begun. 


1 

Date  of 
Inocula- 
tion. 

Material 
used  and 
Source. 

Quan- 
tity 
used. 

Date 
Killed. 

Time 
Elapsed. 

Results. 

1889 

1889 

1 

Jan.  15 

1  of  m. 
CowD. 

5  c.  c. 

March  1 

44  d. 

Negative. 

2 

(( 

ti 

10  c.  c. 

(( 

i( 

(t 

3 

(( 

L.  of  m. 

6c.c. 

(t 

(( 

Negative.      Small    amount 

CowD. 

fluid  in   abdomen, 
tures  sterile. 

Cul- 

4 

Jan.  19 

L.  of  m. 

CowE. 

(1 

(1 

40  d. 

Negative. 

5 

(( 

u 

8  c.  c. 

(( 

(( 

(( 

6 

(( 

1  of  m. 
CowE. 

7c.c. 

Mar.  11 

51  d. 

Negative.     Punctate 
orrhage  in  lungs. 

hem- 

7 

Jan.  22 

1  of  m. 
CowF. 

3  CO. 

Mar.  1 

38  d. 

Negative. 

8 

(( 

11 

(( 

Mar.  11 

48  d. 

(( 

9 

(( 

L.  of  m. 
CowF. 

5  c.  c. 

" 

(( 

(( 

10 

Jan.  26 

1  of  m. 
CowQ. 

(( 

Mar.  12 

45  d. 

(( 

11 

(( 

(( 

(( 

(( 

(( 

(( 

INFECTIOUSNESS   OF  MILK. 
Table  in.  (continued). 


17 


1 

S5 

Date  of 
Inocula- 
tion. 

Material 
used  and 
Source. 

Quan- 
tity 
used. 

Date 
Killed. 

Time 

Elapsed. 

Results. 

12 

Jan.  26 

L.  of  m. 
CowG. 

10  C.  C. 

Mar.  12 

45  d. 

Negative. 

13 

Jan.  29 

1  of  m. 
CowH. 

4  c.  c. 

Mar.  21 

51  d. 

K 

14 

Jan.  29 

1  of  m. 
CowH. 

4  c.  c. 

Mar.  21 

51  d. 

<( 

15 

<( 

L.  of  m. 
CowH. 

10  c.  c. 

(( 

K 

(( 

16 

Feb.  2 

L.  of  m. 
Cowl. 

4  c.  c. 

Mar.  28 

54  d. 

U 

17 

11 

(t 

5  c.  c. 

11 

11 

(( 

18 

(( 

1  of  m. 
Cowl. 

a 

(( 

(( 

(( 

19 

Feb.  5 

1  of  m. 
CowM. 

2  CO. 

Aprils 

57  d. 

(( 

20 

ii 

li 

3c.c. 

(( 

(( 

(( 

21 

(( 

Li.  of  m. 
CowM. 

3.5  c.c. 

(( 

(( 

(( 

22 

Mar.  5 

L.  of  m, 
CowL. 

5  c.  c. 

May  2 

58  d. 

(( 

23 

a 

u 

6  c.c. 

ii 

(1 

Negative.  Wen  under 
throat. 

24 

<( 

1  of  m. 
CowL. 

4e.  c. 

a 

(( 

Negative. 

25 

Mar.  9 

Cream 
before 
death. 
CowP. 

5  c.  c 

May  6 

(( 

Positive.  Pin-head  nodules 
in  spleen,  liver,  kidney, 
and  diaphragm.  -|-  d 
gland  near  liver.  Ba- 
cilli in  all. 

26 

« 

U 

Ic.  c. 

<( 

(( 

Negative. 

27 

(( 

Cream 

after 

death. 

CowP. 

5  c.  c. 

(( 

<( 

Positive.  Nodrde  in  lungs, 
liver,  spleen,  and  perito- 
neum.   Bacilli  in  all. 

28 

(( 

1  of  m. 
Cream, 
CowO. 

4  c.  c. 

(( 

(( 

Negative. 

29 

« 

L.  of  m. 
Milk, 
CowO. 

5  c.  c. 

(1 

(( 

(( 

30 

u 

L.  of  m. 
Cream, 
CowO. 

4  c.  c. 

(( 

u 

Negative.  Nodule  in  edge 
of  liver  =  coccidium  ovi- 
forme. 

31 

Mar.  18 

L.  of  m. 
Cream, 
CowE. 

Ic.c. 

May  28 

75  d. 

Negative. 

32 

(1 

" 

K 

Died 

May  27 

74  d. 

Negative.  Marked  emacia- 
tion. 

33 

i( 

Top 

(sour). 
CowE. 

(1 

May  28 

72  d. 

Negative. 

34 

(( 

1  of  m. 
Cream, 
CowD. 

3  c.c. 

(( 

(( 

(( 

18 


INFECTIOUSNESS   OF  MILK. 


Table   III. 

continiied'). 

1 

Date  of 
Inocula- 
tion. 

Material 
used  and 
Source. 

Quan- 
tity 
used. 

Date 
Killed. 

Time 
Elapsed. 

Besulta. 

35 

Mar.  18 

CowD. 

5  c.  c. 

May  28 

72  d. 

Negative. 

36 

(( 

L.  of  m. 
Cream, 
CowD. 

4  c.  C. 

(( 

(( 

u 

37 

Mar.  19 

L.  of  m. 
Cream, 
CowF. 

0.5  e.e. 

May  31 

73  d. 

Negative.  Coccidium  ovi- 
f  orme  in  liver. 

38 

it 

" 

i( 

(( 

<( 

Negative. 

39 

a 

1  of  m. 
Cream, 
CowF. 

1  c.  c. 

u 

(( 

Negative.    Bladder  worms. 

40 

Mar.  23 

L.  of  m. 
Cream, 
CowG. 

3c.c. 

June  5 

74  d. 

Negative. 

41 

(( 

(I 

Ice. 

(( 

IC 

Material  lost. 

42 

Mar.  26 

1  of  m. 
(sour). 
CowH. 

(1 

a 

71  d. 

Negative. 

43 

u 

ii 

(1 

(( 

t( 

u 

44 

(( 

L.  of  m. 

(sour). 
CowH. 

(( 

u 

(i 

Negative.  Coccidium  ovi- 
f  orme  in  liver. 

45 

Mar.  30 

L.  of  m. 
Cream, 
Cowl. 

(( 

June  6 

68  d. 

(C                                          (( 

46 

May  11 

L.  of  m. 
Cream, 
CowL. 

0.5  c.c. 

July  2 

52  d. 

Negative.  Fibromata  in 
liver. 

47 

(( 

11 

.75  CO. 

(( 

(( 

Positive.    Liver.    Bacilli. 

48 

u 

1  of  m. 
(sour). 
CowL. 

Ic.  c. 

(( 

(( 

Negative. 

49 

Jane  10 

Slocum, 
3  hrs.  to 
milking 

(( 

July  31 
died 

57  d. 

Negative.  Uraemia.  Coc- 
cidium ovif  orme  in  liver. 

50 

« 

" 

(( 

July  31 

(1 

((                     (( 

51 

(( 

(( 

(( 

Aug.  1 

52  d. 

Negative. 

52 

Jane  14 

Milk, 
Saunders 

(( 

Aug.  2 
died 

47  d. 

Negative.    Apoplexy. 

53 

(( 

u 

(( 

(( 

K 

Positive.     Liver.    Bacilli. 

54 

(( 

Cream, 
Saunders 

(( 

Aug.  3 

48  d. 

Positive.  Cheesy  nodule  size 
of  hazel  nut  at  point  of 
inoculation.  Glands  of 
abdomen  +  d.     Bacilli.^ 

55 

June  19 

L.  of  m. 
Mayhew 

(( 

Aug.  6 

<i 

Negative.  Coccidium  ovi- 
forme  in  liver. 

56 

(( 

(( 

(( 

Aug.  3 
died 

45  d. 

il                              u 

57 

June  21 

L.  of  m. 
Cream, 
Mayhew 

(( 

Aug.  8 

48  d. 

Negfative. 

INFECTIOUSNESS   OF  MILK. 
Table   III.  (continued). 


19 


1 

1 

Date  of 
Inocula- 
tion. 

Material 
used  and 
Source. 

Quan- 
tity 
used. 

Date 
Killed. 

Time 
Elapsed. 

Results. 

58 
59 

June  25 

Milk, 
Slocum 

Ic.c. 
(1 

Nov.  3 

u 

131  d. 

Negative. 

(1 

60 

(( 

Cream, 
Slocum 

(1 

(1 

i( 

« 

61 

July  12 

1  of  m. 
CowR. 

Ic.  c. 

(( 

114  d. 

62 

u 

(( 

(( 

Aug.  3 

22  d. 
Died. 

Decomposition  too  rapid  for 
examination. 

63 

It 

L.  of  m. 
Cream, 
CowR. 

(( 

Aug.  5 

24  d. 

Negative.  Death  from  con- 
stipation. 

64 

July  16 

1  of  m. 
CowD. 

l( 

Nov.  6 

113  d. 

Negative.    Coccidia  in  liver. 

65 

11 

a 

l( 

•  « 

i( 

Negative, 

66 

(1 

L.  of  m. 
Cream, 
CowD. 

(1 

(( 

u 

Negative.    Perihepatitis. 

67 

July  19 

1  of  m. 
CowE. 

l( 

(( 

llOd. 

Negative. 

68 

i< 

K 

<( 

(( 

(( 

(( 

69 

K 

L.  of  m. 
CowE. 

(1 

(1 

(( 

(( 

70 

July  25 

1  of  m. 
CowG. 

(( 

Aug.  16 

22  d. 

Negative.  Rupture  of  blad- 
der.   Specimens  lost. 

71 

« 

u 

a 

Nov.  11 

109  d. 

Negative. 

72 

« 

L.  of  m. 
CowG. 

(1 

(( 

(( 

« 

73 

July  27 

1  of  m. 
Cream, 
CowF. 

" 

Nov.  5 

101  d. 

(( 

74 

(( 

" 

(1 

(1 

(( 

(( 

75 

<k 

L.  of  mi. 

Cream, 
CowF. 

(( 

(( 

(( 

(( 

76 

July  30 

1  of  m. 
Cream, 
CowL. 

(( 

Aug.  13 

14  d. 

Negative.  Killed  by  owl 
and  buried  at  farm  with- 
out autopsy. 

77 

(( 

(1 

(( 

Nov.  5 

48  d. 

Negative. 

78 

Sept.  9 

1  of  m. 
Beckett 

5c.c. 

Nov.  11 

64  d. 

u 

79 

(( 

u 

4  c.  c 

K 

(( 

(( 

80 

It 
1890 

L.  of  m. 
Beckett 

Sec. 

l( 

« 

Positive.  Nodule  size  of  a 
pea  at  point  of  inocula- 
tion. Bacilli  in  sections 
and  cover-glasses. 

81 

June  18 

Cream, 
Cow  W. 

3c.  c. 

Aug.  6 

49  d. 

Negative. 

82 

(( 

i( 

2c.c. 

(( 

(( 

(( 

83 

(( 

(1 

4  c.  c. 

(( 

(1 

« 

84 

(1 

Cream, 
Pierce, 
ant.  teat 

2c.c. 

« 

(( 

U 

20 


INFECTIOUSNESS   OF  MILK. 
Table  III.  (continued). 


1 

Date  of 
Inocula- 
tion. 

Material 
used  and 
Source. 

Quan- 
tity 
used. 

Date 
Killed. 

Time 
Elapsed. 

Results. 

85 

Jmie  18 

ant.  teat 

4  c.  c. 

Ang.  6 

49  d. 

Negative. 

86 

11 

K 

(1 

11 

« 

87 

i( 

Ibid., 
hind 
teat 

5  c.  c. 

11 

II 

II 

88 

K 

Ibid., 
hind 
teat 

4  c.  c. 

({ 

t( 

II 

89 

(( 

" 

5  c.  c. 

It 

II 

(( 

90 

l( 

Cream, 
CowY. 

3c.c. 

(( 

II 

« 

91 

(( 

i( 

2.5  c.c. 

(( 

<i 

i( 

92 

(( 

<i 

(( 

<( 

(1 

(1 

93 

(( 

Cream, 
CowX. 

5  c.  c. 

(( 

(1 

II 

94 

(( 

" 

11 

(( 

<i 

Negative.    Coccidia  in  liver. 

95 

(C 

« 

6  c.c. 

11 

«< 

Negative.    Cheesy  nodule  at 
point  of  inoculation  and 
+  d  gland  near.     No  ba- 
cilli found. 

From  this  table  it  appears  that  95  rabbits  were  used  for 
the  same  purposes  and  under  the  same  conditions  as  were  the 
guinea-pigs  in  Table  II.  Of  these  rabbits  five  (Nos.  41,  62, 
63,  70,  and  76)  were  for  various  reasons  useless  for  the  pur- 
poses of  the  investigation,  leaving  90  which  were  subjected 
to  full  examination.  For  these  90  animals  milk  from  19 
different  cows  was  used  one  or  more  times,  and  tuberculosis 
was  found  in  6  animals  inoculated  with  milk  from  four  differ- 
ent cows,  as  follows :  — 


No. 

Source. 

Material  used. 

Results  found  in 

25 
27 
47 
53 
54 
80 

Cow  P. 

11 

CowL. 
Saunders'. 

Beckett. 

Cream  before  death. 

Cream  after  death. 

Cream. 

Milk. 

Cream. 

Cream. 

Spleen,  kidney,  liver,  diaphragm. 

Spleen,  kidney,  liver,  diaphragm. 

Liver. 

Gland. 

Gland. 

Caecum. 

These  results  show  a  less  proportion  of  apparent  infection 
of  the  milk  as  demonstrated  by  the  inoculation  experiments 


INFECTIOUSNESS   OF  MILK. 


21 


than  appeared  to  be  the  case  in  the  microscopic  examinations. 
But  this  difference,  even  granting  that  they  were  all  the 
results  of  the  inoculations,  is  no  more  than  might  be  expected 
and  explained  by  causes  beyond  control. 

ni. 

The  third  line  of  experiment  was  in  feeding  the  milk  from 
tuberculous  cows  and  healthy  udders  to  different  series  of 
animals.  Here  again  the  greatest  precautions  were  taken 
against  outside  infection,  and  it  is  believed  that  these  were  as 
free  from  sources  of  error  as  it  is  ever  possible  to  make  such 
experiments.  They  were  carried  on  upon  rabbits,  pigs,  and 
calves,  and  the  statement  of  the  experiments  is  shown  in 
tables  IV.,  V.,  and  VI. 

TABLE  IV. 

MrLK-FEEDING  EXPERIMENTS  UPON  KaBBITS. 


u 

a 

3 

Date. 

Fed  with  Milk 
from 

Killed. 

Result. 

fc 

1 

Dec.  3, 1889 

Cow  D,  m.  &  e. 

May  4,  1890 

None. 

2 

u 

« 

11 

1 

3 

i( 

(( 

11 

( 

4 

(( 

(( 

May  20 

( 

5 

Aug.  28, 1888 

Cow  I,  m.  &  e. 

Feb. 16, 1889 

( 

6 

u 

it 

11 

( 

7 

(C 

II 

<( 

< 

8 

(( 

(1 

i( 

( 

9 

(C 

<( 

(( 

t 

10 

i( 

<i 

i( 

it 

11 

« 

(I 

It 

Nodules  in  liver.     Material 
lost. 

12 

Feb.  16,  1889 

Cow  E,  m.  &  e. 

Mar.  19 
Died 

Died  while  pregnant.     Both 
lungs  full  of  miliary  tuber- 
cles.    Showing  bacilli. 

13 

(( 

11 

June  8 

Coccidia  in  liver. 

14 

<( 

II 

II 

II                II 

15 

(( 

II 

11 

II                II 

16 

Feb.  25,  1889 

Cow  0,  irregu- 
larly. 

Sept.  14 
Died 

Acute  pneumonia. 

17 

«( 

II 

Sept.  30 

None. 

18 

(( 

<i 

41 

II 

19 

u 

i( 

i( 

II 

20 

u 

i( 

t( 

Coccidia  in  liver. 

21 

M 

u 

<l 

II                11 

22 

M 

u 

(( 

«<                (I 

22 


DTFECTIOUSNESS  OF  MILK. 
Table  IV.  (continued). 


c 

1 

Date. 

Fed  with  MUk 
from 

KiUed. 

Result. 

m 

23 

Dec.  17,  1889 

Cow  E,  m.  &  e. 

Feb.  16,  1890 
Died 

Few  nodules  in  liver  =  small 
inflammatory  nodule. 

24 

(( 

(( 

Mar.  23 

None. 

25 

(( 

(( 

Mar.  24 

Hsematoma  of  liver. 

26 

(( 

(( 

Mar.  25 

Few  spots  in  lung.  Active 
hyperaemia. 

27 

(( 

(( 

Mar.  24 

Congestion  of  lung  and  mil- 
iary tubercle,  —  no  bacilli 
of  tuberculosis. 

28 

(C 

« 

(( 

Miliary  nodule  in  liver  show- 
ing B.  T. 

29 

(( 

a 

<( 

None. 

30 

(( 

(( 

Mar.  31 

Material  thrown  away  by  ac- 
cident. 

31 

(( 

(( 

April  7 

Miliary  nodules  of  liver  = 
micrococci. 

32 

(( 

(( 

May  14 

None. 

33 

(( 

(( 

u 

(( 

34 

<c 

(( 

(( 

(( 

35 

u 

it 

(( 

(C 

36 

u 

(( 

(C 

(( 

37 

« 

(( 

(C 

(( 

38 

(( 

(( 

(C 

(( 

39 

(( 

(( 

(( 

(C 

40 

Feb.  5,  1890 

Cow  V,  m.  &  e. 

May  15 

Coccidia  in  liver. 

41 

(( 

« 

(( 

None. 

42 

(( 

(( 

(( 

(( 

43 

(( 

(( 

(( 

(C 

44 

(( 

(( 

(( 

(( 

45 

.(( 

<( 

« 

(( 

46 

(( 

(C 

u 

(( 

47 

« 

(( 

(C 

(t 

48 

(( 

(( 

(( 

(t 

Forty-eight  animals  experimented  upon.    Two  showed  positive  results.    Both 
fed  upon  milk  of  Cow  E, 

There  were  used  48  animals,  with  positive  results  (tuber- 
culosis) in  two,  and  both  of  these  animals  were  fed  upon 
milk  from  cow  E,  No.  12,  one  nodule  in  luDg,  after  31  days ; 
No.  28,  one  nodule  in  liver  after  97  days. 

This  is  of  course  a  very  small  proportion  of  positive  re- 
sults, but  the  following  table  shows  a  very  different  condition 
of  affairs,  that  is  especially  striking  for  the  reason  that  pigs 
are  not  believed  to  be  unusually  susceptible  to  tuberculosis 
imder  ordinary  conditions. 


rNPECTIOUSNESS   OF  MILK. 

TABLE  V. 
Melk-Feeding  Experiments  upon  Pigs. 


23 


No. 

Age. 

Date. 

Fed  on  Milk  from. 

Killed. 

Result  of  Post-mortem. 

1 

8  weeks 

Mar.  28,  '88 

Cow  E  for  one 
week,  then  cow 
F  and  Surplus. 

July  26,  '88 

Nodules  in  the 
liver  in  which  tubercle 
bacilli  were  found, 
and  a  pleuritic  adhe- 
sion on  left  side. 

2 

i( 

<i 

(( 

(( 

Nodule  in  left  lung, 
nodules  in  liver,  and 
enlarged  submaxil- 
lary lymphatic,  tuber- 
cle bacilli  found  in 
all. 

3 

(( 

u 

It 

Sept.  26, '88 

Nodules  in  liver, 
which,  however,  were 
not  saved. 

4 

(( 

it 

(( 

« 

Nodules  in  liver, 
which,  however,  were 
not  sav^d. 

5 

(( 

<( 

« 

Dec.  11,  '88 

Negative. 

6 

(( 

(( 

<c 

(( 

a 

7 

<( 

({ 

(( 

(( 

Two  little  nodules 
in  spleen,  in  which 
tubercle  bacilli  were 
found. 

8 

(( 

Mar.  '89 

Surplus  milk 

Nov.  21, '89 

A  small  nodule  in 
the  liver,  in  which 
tubercle  bacilli  were 
foimd. 

9 

« 

(( 

(( 

(( 

A  few  yellow  spots 
in  liver,  found  to  be 
enlarged  blood  ves- 
sels. 

10 

(( 

(( 

(( 

11 

A  small  nodule  in 
the  liver,  in  which 
tubercle  bacilli  were 
found.     Plate. 

11 

10  weeks 

Dec.  12,  '89 

Cowa  E  &  L 

May  3,  '90 

Enlarged  mesen- 
teric glands,  and  no- 
dules in  the  liver ; 
the  latter  were  gran- 
ulation tissue,  but  no 
tubercle  bacilli  were 
found  in  either. 

12 

(( 

K 

Cows  M  &  W 

<( 

Enlarged  submax- 
illary lymphatic 
gland,  and  nodules  in 
the  liver,  latter  com- 
posed of  granulation 
tissue.  No  tubercle 
bacilli  found  in  liver, 
gland? 

24 


INFECTIOUSNESS  OP  MILK. 


Twelve  healthy  animals  were  used  with  positive  results 
(demonstration  of  the  bacilli  under  the  microscope)  in  five. 
In  two  others,  nodules  presenting  the  gross  appearance  of 
tuberculosis  were  foimd,  but  the  material  was  not  saved  for 
microscopic  examination.  In  any  case,  nearly  fifty  per  cent, 
of  the  animals  were  shown  to  be  tuberculous,  as  foUows  :  — 


No. 

Material  used. 

Besults  found  in 

1 
2 
7 
8 
10 

Cows  E  and  F. 
Cows  E  and  F. 
Cows  E  and  F. 
Surplus  Milk. 
Surplus  Milk. 

Liver. 

Liver,  lung,  and  gland. 

Spleen. 

Liver. 

Liver. 

For  the  purposes  of  the  third  series  of  feeding  experiments, 
calves  were  bought  as  young  as  possible,  and  from  as  healthy 
parentage  as  could  be  found. 

There  were  twenty-five  calves  used  in  this  series  of  experi- 
ments, but  of  these  four  (G,  T,  U,  and  X)  are  to  be  ex- 
cluded from  the  count,  leaving  21. 


TABLE  VT. 

MiLK-FEEDINa  EXPEKIMENTS   UPON  CaLVES. 


Ko. 

Age  and 
Date. 

Parentage 
and  Source. 

Fed  on  Milk  from. 

Killed. 

Result  of  Post-mortem. 

A. 

6  days  old 

Grade  Hol- 

Cow  A  to  Feb. 

Sept.  26, '88 

Nodules  found    in 

Feb.  18,'88 

stein. 

27.     Then  Cows 

right  lung,  liver  and 

healthy. 

A  &  B  to  Mar. 

an  enlarged   medias- 

Mattapan. 

19.     Then  Cows 

tinal  lymphatic.     Tu- 

Heifer. 

A    &    C    until 
killed. 

bercle  bacilli  found 
in  lung.  Other  or- 
gans ? 

B. 

4  days  old 

Red  native 

Cows  B    (S;   C 

July  6,  '88. 

Enlarged  mediasti- 

Feb. 29,'88 

heifer. 

Feb.  29  to  Apr. 

nal   and    pharyngeal 

healthy. 

8,  then  Cows  B 

lymphatics,     nodules 

Mattapan. 

&H. 

in  liver  and  two  no- 
dules in  anterior  lobe 
of  right  lung.  2V 
bercle  bacilli  found  in 
sections  of  lung.  See 
plate. 

INFECTIOUSNESS   OF  MILK. 
Table  VI.   (continued). 


25 


No. 

Age  and 
Date. 

Parentage 
and  Source. 

Fed  on  Milk  from. 

EUIed. 

Result  of  Post-mortem. 

c. 

3  days  old 

Healthy. 

CowE. 

Sept.  26,'88 

Slightly     enlarged 

Apr.  3,  '88 

Jamaica 
Plain. 

mediastinal  lym- 
phatic. Not  tubercu- 
lous. 

D. 

3  days  old 

Healthy. 

CowD. 

<( 

A  few  nodules  in 

Apr.  9,  '88 

Jamaica 
Plain. 

the  liver,  in  which 
tubercle  bacilli  were 
found.     See  plate. 

E. 

3  days  old 

Healthy. 

Cow  J. 

Jan.  9,  '89 

None. 

July  9,  '88 

Roxbury. 

F. 

2  days  old 

Healthy. 

Cowl. 

Apr.  10,  '89 

A  few  nodiJes  in 

Sep.  24, '88 

Jamaica 
Plain. 

liver  and  kidney,  tu- 
bercle bacilli  found 
in  latter. 

G. 

5  days  old 

Healthy. 

Cows  D  &  G. 

(( 

A  few    small    no- 

Oct. 19,  '88 

Mattapan. 

dules  in  liver,  speci- 
men lost. 

H. 

10  days  old 

Healthy. 

Cows  E  &  F. 

(( 

A  nodule  at  lower 

Dee.  4,  '88 

Canterbury. 

border  of  liver,  in 
which  tubercle  bacilli 
were  found. 

I. 

1  day  old 

Healthy. 

CowL. 

Aug.  13,' 89 

Two    small    white 

Feb.  18,'89 

Mattapan. 

spots  in  liver,  and  a 
mottled  appearance  of 
one  kidney.  Kidney 
negative.  Liver  (?) 

J. 

2  days  old 

Healthy. 

Cow  0,  helped 

(( 

Enlarged      mesen- 

Feb. 25,'89 

Jamaica 

out   by  healthy 

teric    lymphatics    in 

Plain. 

CowK. 

which  tubercle  bacilli 
were  found.  Kidney 
like  calf  I's,  nega- 
tive. 

K. 

1  day  old 

Healthy  (?) 

Cow   M    from 

(( 

Chronic  interstitial 

Mar.29,'89 

mother. 
Mattapan. 

Apr.  13. 

pneumonia  right  lung, 
nodule  in  liver,  con- 
gested kidney.  Not 
tuberculous.     Plate. 

L. 

5  days  old 

Healthy. 

Cow    Q     (calf 

(C 

Negative. 

May  1,  '89 

Brookline. 

had  cough  June 
3  to  Aug.  1). 

M. 

2  days  old 

Healthy. 

Cow    R     (calf 

(( 

Nodules  in  liver  in 

May  3,  '89 

Jamaica 

had  cough  June 

which  tubercle  bacilli 

Plain. 

18  to  Aug.  1). 

were  found.  Kidneys, 
negative. 

N. 

7  days  old 

Healthy. 

CowD. 

Nov.  21,  '89 

Nodules    in    liver. 

May  16, '89 

Jamaica 
Plain. 

and  slightly  enlarged 
mesenteric  glands. 
No  tubercle  bacilli 
found  in  either. 

0. 

6  days  old 

Healthy. 

Cow  F  to  June 

<( 

One  nodule  in  liver, 

May  23, '89 

Jamaica 
Plain. 

1,  then  Cow  E. 

negative.  Mesenteric 
lymphatic  (?) 

P. 

5  days  old 

Healthy. 

CowS. 

Mar.  4,  '90 

Negative. 

July  18,'89 

Mattapan. 

26 


INFECTIOUSNESS    OF  MILK. 
Table  VI.  (continued). 


No. 

Age  and 
Date. 

Parentage 
and  Source. 

Fed  on  Milk  from. 

KiUed. 

Result  of  Post-mortem. 

Q. 

3  days  old 

Healthy. 

CowL 

Mar.  4,  '90 

A  few  nodules  in 

Aug.  3,  '89 

Jamaica 
Plain. 

liver,  negative.  A 
bair  ball  about  size  of 
a  base  ball  in  the  ru- 
men. 

R. 

11  days  old 

Healthy. 

CowG. 

u 

A  few  nodules  in 

Aug.!22,'89 

Mattapan. 

the  liver.  Not  tuber- 
culous. 

Nodules    in    liver, 

S. 

4  days  old 

Healthy. 

CowV. 

(( 

Oct.  22, '89 

Jamaica 
Plain. 

negative.  Slightly 
enlarged  pharyngesJ 
lymphatics  ? 

T. 

5  days  old 

Healthy. 

CowX. 

June  25,  '90 

Negative.     Cow  X 

Mar.  11,'90 

Mattapan. 

proved  to  be  not  tu- 
berculous. 

U. 

5  days  old 
Mar.  11,'90 

(( 

CowL. 

(( 

Enlarged  mesen- 
teric glaoads. 

V. 

3  days  old 
Mar.  18,'90 

(( 

CowM. 

u 

Enlarged  spleen 
given  to  Dr.  Jeffries. 
Contained  no  tubercle 
bacilli. 

W. 

14  days  old 
Apr.  7,  '90 

(( 

CowS. 

(( 

Cheesy  nodule  in 
lung,  in  which  tuber- 
cle bacilli  were  found. 
Red  spot  in  liver  ? 

X. 

4  days  old 

(( 

CowY. 

Apr.  16 

Pneumonia        and 

Apr.  7,  '90 

Moribund 
&  killed. 

pleurisy,  enlarged 
mediastinal  lymphat- 
ics, enlarged  spleen. 
Dr.  Jeffries  found  his 
swine  disease  organ- 
ism in  these  speci- 
mens. 

Y. 

3  days  old 
May  31, '90 

(C 

CowY. 

June  25, '90 

Small  yellow  spot 
in  liver.  Microscopic 
ex.  =  negative. 

INFECTIOUSNESS  OF  MILK. 


27 


Of  these  twenty-one  animals,  eight,  or  over  33^,  were 
shown  to  be  tuberculous,  as  follows  :  — 


Letter. 

Milk, 

Result  in 

A 

Cow  A-A  and  B, 

F. 

Lnng. 

B 

Cow  B  and  C,  B  and  H. 

Lung. 

D 

CowD. 

Liver. 

F 

CowF. 

Kidney. 

H 

Cow  E  and  F. 

Liver. 

J 

CowO. 

Gland. 

M 

CowR. 

Liver. 

W 

CowS. 

Lung. 

It  is  of  course  true  that  pigs  and  calves,  that  drink  milk 
much  more  freely  than  do  rabbits,  are  more  susceptible  to 
infection  by  the  gastro-intestinal  tract,  and  that  this  may  ex- 
plain the  far  greater  proportion  of  positive  results  in  these 
two  species  of  animals. 

That  the  cows  from  which  the  milk  for  these  feeding  ex- 
periments was  derived  were  free  from  tuberculosis  of  the 
udder,  is  shown  by  the  following  table  of  their  histories,  and 
the  results  of  the  post-mortem  examinations. 


28 


hH       Eel 


INFECTIOUSNESS  OF  MILK. 


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INFECTIOUSNESS  OF  MILK.  29 


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INFECTIOUSNESS   OF  MILK. 


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reathing ;      enlarged 
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INFECTIOUSNESS   OF  MILK. 


31 


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32 


INFECTIOUSNESS   OF  MILK. 


Examination  of  Cows  used  for  Experiment. 

Twenty-three  of  the  twenty-five  cows  shown  upon  this  table 
were  used  for  the  feeding  experiments,  and  in  not  one  of 
them  did  the  most  careful  macroscopic  and  microscopic  search 
show  any  sign  of  tuberculosis  of  the  udder  except  in  one, 
Cow  F,  and  in  this  case  a  single  giant  cell,  containing  one 
bacillus,  was  found  in  one  section,  and  no  other  indication  of 
tuberculosis  anywhere  else  in  the  udder.  In  all  of  these 
cows,  however,  tuberculosis  was  demonstrated  to  be  present 
in  some  other  part  of  the  body  than  the  udder. 

An  exceedingly  interesting  piece  of  evidence  as  regards 
the  hereditary  nature  of  tuberculosis  is  found  in  the  history 
of  nineteen  calves  born  of  these  tuberculous  cows  with  healthy 
udders,  and  shown  in  the  following  table. 

TABLE  Vin. 
Condition  of  CAiiVES  from  Tuberculous  Cows  kept  at  Farm. 


No. 

Mother. 

Bom. 

KUled. 

1 

Cow 

1888 

1888 

2 

D 
D 

Apr.  5 

1889 

Apr.  6 

1889 

3 

E 

Apr.  29 

1888 

May  4 

1888 

March  23 

March  24 

4 

E 

1889 

1889 

5 

E 

May  26 

1890 

June  1 

1890 

June  18 

June  21 

6 

F 

1888 

1888 

7 

F 

May  14 

1889 

May  14 

1889 

8 

G 

May  5 

1888 

May  9 

1888 

Apr.  15 

Apr.  16 

9 

G 

1889 

1889 

10 

H 

July  15 

Nov.  21 

1889 
Aug.  10 

Result  of  Post-mortem. 


Perfectly  healthy. 


Foetal  membranes  covered  with  nodules. 
Slight  atalectasis  of  left  lung.  Mesen- 
teric lymphatics  large,  but  no  more  so 
than  usual  in  a  young  animal. 

Healthy. 


Healthy,  enlarged  mesenteric  glands, 

but  normal. 
Healthy. 

Healthy,  except  a  few  nodules  on  peri- 
cardium and  peritoneum.  (Did  not  look 
tuberciilous.  Material  lost.)  (Haemo- 
lymph  glands  ?) 

Healthy,  except  a  few  nodiJes  on  edge 
of  liver,  found  to  be  nothing  abnormal. 

A  five  months'  foetus.  Nodules  on 
membranes  and  cord,  foetus  healthy.  No 
record  of  micros,  ex. 


INFECTIOUSNESS   OF  MILK. 
Table  VIII.   (continued). 


33 


No. 

Mother. 

Born. 

KiUed. 

Result  of  Post-mortem. 

11 

I 

1888 

1888 

Healthy,  except  mesenteric  lymphatics 

July  11 

July  12 

appeared  large.  (Not  more  so  than  many 
others  that  are  normal.) 

12 

I 

1889 
July  25 

1889 
July  31 

Healthy. 

13 

I 

1890 
March  4 

A  six  months'  foetus,  normal  except 
nodules  on  membranes. 

14 

J 

1888  _ 

1888 

Healthy,    mesenteric    lymphatics    ap- 

June 15 

June  16 

peared  large. 

15 

L 

1890 
March  3 

1890 
March  18 

Healthy. 

16 

M 

1889 
March  30 

1889 
Apr.  4 

u 

17 

M 

1890 
March  15 

1890 
March  18 

l( 

18 

0 

1889 

1889 

Calf  died,    death    due    to  bronchitis. 

May  31 

June  4 

healthy  as  far  as  tuberculosis  is  con- 
cerned. 

19 

S 

1890 
March  31 

1890 
March  31 

Healthy. 

Of  these  nineteen  calves,  all  killed  within  six  days  after 
birth,  not  one  showed  any  detectable  evidence  of  tuberculosis, 
and  a  most  careful  search  was  made  in  all  cases.  So  that  this 
certainly  seems  to  point  away  from  any  very  active  transmis- 
sion of  tuberculosis  from  the  cow  to  its  offspring. 

IV. 

As  an  interesting  corollary  to  the  work  already  detailed,  a 
series  of  microscopic  examinations  and  inoculation  experi- 
ments were  made  with  milk  taken  at  random  from  the  mixed 
supply  of  the  city  of  Boston.  The  samples  were  obtained 
from  the  Inspector  of  Milk,  and  the  work  done  is  exhibited 
in  Tables  IX.  and  X. 


34 


INFECTIOUSNESS  OF  MILK. 


TABLE   IX. 

C0VBB-GLA.S8  Examination  of  Milk  and  Cream  from  Milk  Supplt  of 
City  of  Boston. 


No. 


Source. 


Date. 


1 

Milkl. 
Cream. 

Feb.  15 

2 

Milk  1. 
Sediment. 

u 

3 

Milk  2. 
Cream. 

(( 

4 

Milk  2. 
Sediment. 

(t 

5 

Milk  3. 
Cream. 

a 

6 

Milk  3. 
Sediment. 

(( 

7 

Milk  4. 

Cream. 

(( 

8 

Milk  4. 
Sediment. 

11 

9 

Milk  140. 
Cream. 

Feb.  22 

10 

Milk  30. 
Cream. 

(( 

11 

Milk  270. 
Cream. 

(( 

12 

"  Draper." 
Cream. 

(( 

13 

MUk  468. 
Cream. 

(( 

14 

Milk  391. 
Cream. 

(( 

15 

5683  d. 
Milk. 

(( 

16 

3697  d. 
Milk. 

Maxch  1 

17 

3687  d. 
Milk. 

(1 

18 

3701  d. 
Milk. 

(C 

19 

"  LoweU." 
Cream. 

March  6 

20 

"  LoweU." 
Milk. 

(( 

21 

3849  d. 
Cream. 

March  10 

22 

3849  d. 
Milk. 

(( 

23 

3845  d. 
Cream. 

(( 

24 

384  d. 
Milk. 

(1 

25 

3851  d. 
Cream. 

(( 

26 

3851  d. 
Milk. 

(( 

27 

3847  d. 
Cream. 

(( 

Result. 


Negative. 


INFECTIOUSNESS   OF   MILK. 
Table  IX.   (continued). 


35 


No. 

Source. 

Date. 

Result. 

28 

3847  d. 
MQk. 

March  10 

Negative. 

29 

3973  d. 
Cream. 

March  14 

(( 

30 

3973  d. 
MUk. 

(( 

« 

31 

3979  d. 
Cream. 

<( 

(( 

32 

3979  d. 
MUk. 

(C 

(( 

33 

4125  d. 
Cream. 

March  26 

u 

34 

4125  d. 
MUk. 

(( 

u 

35 

4121  d. 
Cream. 

(( 

u 

36 

4121  d. 
Milk. 

(( 

u 

37 

4123  d. 
Cream. 

11 

u 

38 

4123  d. 
Milk. 

11 

u 

39 

4315  d. 
Cream. 

Aprils 

it 

40 

4315  d. 
MUk. 

« 

u 

41 

4325  d. 
Cream. 

(( 

Bacilli  found. 

42 

4325  d. 
MUk. 

u 

Negative. 

43 

4637 
Cream. 

Apriiie 

(( 

44 

46.37 
MUk. 

a 

M 

45 

4617 
Cream. 

(( 

« 

46 

4617 
MUk. 

<( 

u 

47 

4629  d. 
Cream. 

(C 

(( 

48 

4629  d. 
Milk. 

(( 

(( 

49 

4619  d. 
Cream. 

(( 

(( 

50 

4619  d. 
Milk. 

(( 

« 

51 

4797  d. 
Cream. 

AprU28 

(( 

52 

4797  d. 
Milk. 

« 

(( 

53 

4809  d. 
Cream. 

<( 

(C 

54 

4809  d. 
MUk. 

(( 

u 

55 

4815  d. 
Cream. 

(( 

u 

56 

4815  d. 

« 

<( 

MUk. 

36 


INFECTIOUSNESS   OF  MILK. 


The  table  shows  that  there  were  fifty-six  examinations 
made  of  the  milk  and  cream  from  thirty-three  samples,  with 
the  result  of  demonstrating  the  presence  of  the  bacilli  of 
tuberculosis  once.     (No.  41.) 

TABLE  X. 

Inoculations  with  Milk  from  Milk  Supply  of  the  City  of  Boston. 

Babbits. 


No. 


10 

11 

12 

13 

14 
15 

16 
17 

18 


Date  Inoc- 
ulated. 

Source  of 
Material. 

1890 
Feb.  22 

Cream  140, 
Subcu. 

u 

(( 

Cream  30, 

li 

(( 

Cream  270, 

(( 
(( 

Creamfrom 

"  Draper's" 

milk. 

March  1 

Sediment 
of  5683  d. 

(C 

(( 

(( 
(( 

Sediment 
of  3697  d. 

(C 

(( 

Sediment 
of  3687  d. 

(1 

Sediment 
of  3701  d. 

March  6 

Cream, 
"Lowell" 

milk. 

u 

Quantity 
Used. 

Date 
KiUed. 

3  CO. 

May  8 

(( 

11 

(( 

II 

(( 

II 

2  c.  c. 

May  12 

1  C.  0. 

K 

4  c.  c. 

Died 
Feb.  25 
May  12 

<( 

11 

3c.  c. 
4  c.  c. 

Died 
AprU8 

Died 
March  5 
May  12 

3  c.  c. 

4  c.  c. 

II 
May  15 

a 

II 

4  e.  c. 

May  8 

II 

II 

Result. 


Negative. 


Bladder     worms ;     nodule     in 

liver;  granulation  tissue  and 

baeiUi. 
Negative. 
Negative. 
Enlarged  mesenteric  gland  and 

nodule   in  liver ;    no  bacilli  ; 

coecidia  in  liver. 
Negative ;  great  emaciation. 


No  autopsy. 

Bladder  worms;  nodules  in 
liver,  and  two  in  spleen ;  no- 
dules cheesy ;  but  no  bacilli, 
and  no  coecidia. 

Nodules  in  cseeum  ;  cover- 
glasses  and  sections  showed 
coecidia  and  bacilli  of  tuber- 
culosis. 

Negative. 


Negative.    Coecidia  in  csecnm. 

Negative. 

Negative.     Bladder  worms. 
Negative. 


Enlarged  spleen,  and  nodules  in 
caecum  and  liver ;  coecidia  in 
last  two. 


INFECTIOUSNESS   OF  MILK. 
Table  X.  (continued). 


37 


No. 


19 


20 


21 

22 
23 

24 

25 

26 

27 
28 


Date  Inoc- 

Source of 

Quantity 

Date 

ulated. 

Material. 

Used. 

Killed. 

Majch  6 

Sediment  of 

"LoweU" 

milk. 

4  c.  e. 

May  8 

(( 

u 

(( 

Died 
May  5 

Mch.  11 

Cream 
3845  d. 

Si  c.  c. 

May  15 

(( 

" 

" 

u 

Cream 
3849  d. 

4  c.  c. 

(( 

(( 

(( 

Mch.  12 

Upper  B. 
Robinson. 

4  c.  c. 

(( 

a 

(f 

(( 

(( 

« 

Died 
March  12 

(C 

u 

(t 

May  15 

Result. 


Negative. 


Acute  peritonitis  from  rupture  ; 
spleen  much  enlarged,  and 
many  nodules  all  over  intes- 
tinal wall ;  bacilli  in  spleen  ; 
plate  photograph. 

Nodules  in  caecum ;  coccidia. 

Negative. 

Negative.  Calcareous  nodule  in 
liver  not  examined. 

Negative.  Nodules  in  csecum  ; 
negative. 

Negative.  Few  nodules  in  liver 
and  csecum  ;  material  lost. 

Negative.  Csecum  coccidia;  some 
infiltration  at  point  of  inocu- 
lation. 

Acute  general  peritonitis ;  nega- 
tive. 

Yellow  nodule  at  point  of  inocu- 
lation ;  no  b.  Csecum  coccidia ; 
liver,  small  nodule ;  no  bacilli ; 
emaciation. 


In  this  table  the  result  of  the  inoculations  of  this  milk  is 
shown,  and  by  it  it  appears  that  there  were  twenty-eight  rab- 
bits used,  of  which  three  (Nos.  8,  25,  and  27)  are  to  be  ex- 
cluded, leaving  twenty-five  in  which  the  investigation  was 
completed.  Among  these  twenty-five  there  were  positive  re- 
sults in  three,  as  follows :  — 


Number. 

Material. 

Results. 

3 
10 
20 

Cream  30. 
Milk,  5683  d. 
Lowell  milk. 

Liver. 

Csecum. 

Spleen. 

Of  course  these  results,  obtained  in  milk  from  a  mixed 
source,  are  not  as  conclusive  upon  the  especial  point  toward 


38  INFECTIOUSNESS   OF  MILK. 

which  the  main  line  of  investigation  was  directed,  —  as  to 
the  presence  of  the  bacilli  of  tuberculosis  in  mUk  from  cows 
with  healthy  udders,  —  but  they  certainly  tend  to  demon- 
strate that  there  may  be  this  infectious  element  in  any  milk 
supply  from  uninspected  cattle. 

V. 

The  last  of  the  lines  in  which  investigation  was  made  was 
to  endeavor,  if  possible,  to  obtain  clinical  reports  of  cases  of 
transmission  through  milk  from  mother  to  offspring,  and  evi- 
dence was  sought  in  this  direction  as  follows  :  — 

In  January  and  February  of  the  year  1890  a  circular  was 
sent  out  to  about  eighteen  hundred  medical  and  veterinary 
gentlemen,  in  an  attempt  to  discover  any  clinical  cases  bear- 
ing upon  the  subject  at  hand.  The  list  was  chosen,  in  the 
first  place,  from  the  members  of  the  Massachusetts  Medical 
Society  of  at  least  five  years'  standing,  and  was  then  filled 
out  with  the  names  of  the  members  of  the  American  Surgical 
Association,  the  Association  of  American  Physicians,  and  one 
or  two  of  the  other  sjDecial  societies  of  the  country.  The 
names  of  the  veterinarians  were  taken  from  the  rolls  of  the 
United  States  Veterinary  Association,  and  included  those 
who  were  thought  to  have  had  enough  experience  to  make 
their  observation  of  possible  value  in  this  direction,  in  the 
same  way  as  the  list  of  medical  men  was  completed.  A  copy 
of  the  circular  follows :  — 

Habvaed  Medical  School,  Bacteriological  Labobatoet, 
Boston,  January,  1890. 

Dear  Sir,  —  It  is  desired  to  obtain  a  collection  of  statis- 
tics upon  the  following  point :  Have  you  ever  seen  a  case  of 
Tuberculosis  which  it  seemed  possible  to  you  to  trace  to  a 
milk  supply  as  a  cause  ? 

An  answer  upon  the  inclosed  postal  card  will  greatly  oblige 
Yours  very  truly, 

Harold  C.  Ernst,  M.  D. 
Dr. . 


INFECTIOUSNESS   OF  MILK.  39 

With  each  one  of  these  circulars  was  inclosed  a  postal  card 
with  my  address  printed  upon  it,  so  that  the  way  for  an  an- 
swer should  be  made  as  easy  as  possible. 

The  object  in  sending  out  this  circular  letter  was  not  in  the 
hope  of  obtaining  many  exact  observations,  for  it  must  be 
granted  at  once,  and  without  argument,  that  the  clinical  re- 
ports of  such  cases  as  are  here  inquired  after  must  be  of 
small  value  from  the  point  of  view  of  experimental  science ; 
it  was,  however,  our  wish  to  see  if  there  were  an  opinion 
among  the  medical  profession  at  large  in  favor  of  such  a 
source  of  tuberculosis,  and  if  so,  how  far  that  opinion  ex- 
tended. The  results  obtained  seem  to  have  justified  the  time 
and  expense  of  the  investigation ;  for,  of  all  the  replies  re- 
ceived, but  an  extremely  small  number  have  expressed  a  dis- 
belief in  the  possibility  of  such  an  origin  of  the  disease,  a 
very  large  nimiber  have  shown  how  widespread  the  suspicion 
of  it  has  extended,  and  a  considerable  number  have  replied 
that  they  have  either  suspected  such  an  origin  or  give  cases 
to  exemplify  it.  This  appears  to  be  the  more  remarkable, 
for  the  reason  that  even  the  infectious  nature  of  tuberculosis 
has  been  so  little  suspected  in  some  parts  of  the  country  until 
recently,  and  still  more  so  because  the  discovery  of  the  in- 
fectious agent  and  the  scientific  proof  of  its  power  has  been 
a  matter  of  so  short  a  time. 

In  all  cases  in  which  there  seemed  to  be  a  loophole,  from 
the  form  of  the  answer  on  the  postal  card,  to  think  that  the 
writer  had  suspected  the  existence  of  such  a  case  in  his  own 
or  a  friend's  practice,  a  letter  was  sent  asking  for  further  de- 
tails ;  to  most  of  these,  however,  there  was  either  no  reply, 
or  else  it  was  said  that  nothing  was  meant  by  the  form  of  ex- 
pression used.  To  those  gentlemen  who  took  the  trouble  to 
answer  the  inquiries  sent  them  our  thanks  are  certainly  due, 
and  are  rendered  with  pleasure. 

The  correspondence  is  given  somewhat  fully,  but  purposely 
so,  in  order  to  show,  as  completely  as  may  be,  the  opinion  of 
the  medical  profession  at  large  upon  this  question.     Every 


40  INFECTIOUSNESS   OF  MILK. 

one  of  the  objectors  is  quoted  in  full,  although  none  of  them 
gave  any  very  full  reasons  for  their  disbelief  in  this  method 
of  transmission  of  the  disease.  If  they  had  done  so  it  would 
have  been  a  pleasure  to  have  received  their  letters. 

The  statistics  that  are  drawn  from  this  correspondence  are 
founded  entirely  upon  what  is  given  here,  and  are  open  to 
any  criticism  that  may  be  directed  against  them  by  reason  of 
personal  opinion,  or  facts  that  can  be  brought  against  them 
by  other  observers.  It  is  acknowledged  that  they  are  not 
absolute,  and  that,  being  limited  to  the  one  point  spoken  of, 
they  do  not  show  many  others  that  would  be  of  interest.  It 
may  also  be  that  many  of  the  gentlemen  who  replied  in  the 
negative  might  have  given  a  positive  reply  if  they  supposed 
that  the  inquiry  extended  beyond  cow's  milk,  for  many  of 
them  specified  this  form  of  milk  in  their  replies.  It  is,  how- 
ever, believed  that,  taken  as  a  whole,  there  is  much  of  value 
that  may  be  drawn  from  a  careful  perusal  and  coUation  of 
the  letters. 

The  correspondence  foUows  ;  the  letters  from  medical  men 
are  included  between  number  1  and  number  168,  whilst  the 
replies  of  the  veterinarians  run  from  169  to  180. 

1. 

No,  neither  to  milk,  nor  other  animal  food. 

B.  F.  D.  Adams,  Colorado  Springs. 


Though  I  have  made  diligent   inquiry  for   the  past  six 
years,  in  many  cases,  I  have  never  once  been  able  to  trace  a 
case  of  tuberculosis  to  a  milk  supply  as  a  possible  source. 
Yours  very  truly,  John  P.  Bryson. 

St.  Louia. 

3. 

30th  &  OuvE  Sts.,  St.  Louis,  February  10,  1890. 
Dear  Doctor,  —  I  have  thought  it  worth  while  to  do  a 
little  more  than  merely  answer  your  inquiry  in  regard  to  the 


INFECTIOUSNESS   OF  MILK.  41 

origin  of  tuberculosis  in  a  milk  supply.  I  ought  to  say  that 
my  experience  of  the  disease  is  ahnost  wholly  confined  to 
"  Tuberculosis  Uro-Genitalis."  In  the  past  six  years  I  have 
studied  a  great  many  of  these  cases,  and  in  the  great  majority 
the  respiratory  organs  were  found  by  me,  and  others  who 
aided  me,  to  be  free  of  the  disease,  —  in  the  beginning  at  any 
rate,  —  not  being  affected  except  in  the  latest  stages,  and 
sometimes,  rarely,  not  at  all.  In  all  my  carefully  studied 
cases,  the  disease  seemed  to  have  reached  the  organs  through 
the  haematic  channels.  In  my  case-book,  there  is  recorded 
one  case  where  the  disease  began,  apparently,  in  the  left 
testis  as  three  tubercular  nodules.  The  patient  (married 
and  aged  36)  declared  to  me  that  he  had  never  taken  any 
milk  into  his  stomach  since  he  was  a  child,  —  the  thought  of 
it  making  him  sick.  My  very  great  interest  in  the  subject 
has  prompted  this  note,  and  I  am  pleased  to  see  that  the 
source  of  infection  is  being  studied. 

Very  truly  yours, 

John  P.  Bryson. 

To  Dr.  Harold  C.  Ernst,  Boston. 

4.  (^Reply  to  above.') 

Boston,  February  14, 1890. 
My  dear  Doctor,  —  Accept  my  thanks  for  your  very 
kind  reply  to  my  circular  letter  in  regard  to  tuberculosis  and 
milk.  I  hope  that  I  shall  be  able  to  get  together  some  sort 
of  basis  for  action  in  regard  to  controlling  the  use  of  milk 
from  tuberculous  cows.         Very  truly  yours, 

Harold  C.  Ernst. 

To  John  P.  Bkyson,  Esq.,  M.  D.,  St.  Louia. 

5. 

I  have  no  positive  knowledge  of  such  a  case  as  you  refer 
to  in  your  circular. 

J.  Byrne,  Brooklyn,  N.  Y. 

March  17,  1890. 


42  INFECTIOUSNESS   OF   MILK. 

6. 
42  W.  36th  St.,  New  York,  Febroary  7, 1890. 

Dr.  H.  C.  Ernst. 

Dear  Sir,  —  In  reply  to  your  inquiry  as  to  whether  I 
have  ever  seen  a  case  of  tuberculosis  which  I  have  been  able 
to  trace  to  a  milk  supply  as  a  cause,  I  can  only  say  that  I  am 
unable  to  give  you  any  information,  having  never  made  such 
an  inquiry.  I  am  personally  much  interested  iu  the  subject, 
as  my  breakfast  for  the  past  twenty  years  has  been  a  bowl  of 
bread  and  milk  with  a  cup  of  coffee.  So  far,  I  have  escaped 
contagion.  Your  inquiry  is  a  very  important  one,  and  I  shall 
keep  the  subject  in  mind  carefully  in  the  future.  In  the 
meanwhile  I  shall  continue  my  usual  breakfast. 

Yours,  A.  B.  Ball. 

7.  (JReply  to  ahove.^ 

Boston,  February  8, 1890. 

My  dear  Doctor,  —  I  am  obliged  to  you  for  your  per- 
sonal note  in  reply  to  my  letter  asking  for  information  in 
regard  to  tuberculosis  and  milk.  The  matter  seems  to  me  to 
be  one  of  extreme  importance,  but  the  last  thing  I  desire  to 
be  considered  is  an  "  alarmist."  The  evidence  to  be  derived 
from  this  letter  is  to  be  used  in  connection  with  certain  ex- 
perimental evidence  ...  in  order  to  an  attempt  to  obtain  a 
restriction  of  the  sale  of  milk  from  tuberculous  cows.  .  .  .Your 
expression  of  interest  is  my  apology  for  intruding  upon  you 
again.  Very  truly  yours,        Harold  C.  Ernst. 

A.  B.  Ball,  Esq.,  M.  D. 

8. 

February  10,  1890. 
Never  saw  such  a  case  of  tuberculosis  that  I  can  feel  cer- 
tain of,  and,  since  we  are  acquiring  the  bacilli  through  the  air 
so  abundantly  and  constantly,  don't  think  we  need  fear  the 
milk  source  of  infection  greatly.  The  fact  is,  those  who  can, 
kill  the  bacilli,  however  acquired,  —  those  who  cannot  are 
kiUed  by  them.  N.  Bridge,  Chicago. 


INFECTIOUSNESS   OF  MILK.  43 

9. 

WoBURN,  February  20, 1890. 

Dr.  H.  C.  Ernst. 

Dear  Doctor,  —  In  answer  to  your  circular  letter,  I 
would  say  that  in  two  instances  I  thought  that  tuberculosis 
was  clue  to  the  milk  supply,  but  I  was  unable  to  make  such  a 
connection  as  was  satisfactory  even  to  myself. 

Yours  truly,  Geo.  P.  Bartlett. 

10.  (^Reply  to  ahove.^ 

BosTOK,  February  23, 1890. 
My  dear  Doctor,  —  WiU  you  not  be  good  enough  to 
give  me  the  details  in  regard  to  the  two  cases  where  you 
suspected  the  origin  of  tuberculosis  from  milk  ?  I  want  sus- 
picious cases  as  well  as  those  where  the  facts  are  perfectly 
plain,  because  the  sentiment  of  the  medical  profession  is  as 
important  as  reports  of  cases.  I  hope  that  you  will  feel  like 
doing  what  I  ask.  Very  truly  yours, 

Harold  C.  Ernst,  Harvard  Medical  School. 
Dr.  Geo.  P.  BARiiiETT. 

(2b  this  no  answer  was  received.') 

11. 

Dear  Doctor,  —  I  cannot  answer  to  your  note  as  fuUy  as 
I  would  like  to,  for  the  reason  that  I  do  not  know  whether  it 
relates  to  a  too  great  or  too  scant  supply.  But  I  will  say 
that  in  all  my  cases,  which  have  come  under  my  care  in  mid- 
wifery, which  have  been  quite  numerous,  —  3400,  —  I  have, 
during  fifty  years'  practice,  had  only  two  which  were  so  dis- 
tinctly marked  as  to  give  me  the  utmost  assurance  that  first, 
they  were  well-developed  cases  of  tuberculosis,  and  secondly 
they  could  be  distinctly  traced  to  almost  a  total  lack  of 
milk  secretion.  I  have  intended  to  arrange  my  cases  by 
classification,  but  I  am  so  feeble  that  I  could  not  imdertake 
the  task.  I  may  be  able  to  give  you  a  fuller  synopsis. 
Fraternally, 
D.  Hovte  Batchelder,  Danversport,  Mass. 


44  INFECTIOUSNESS   OF   MILK. 

12. 

Lynn,  February  8,  1890. 

Dear  Doctor,  —  In  reply  to  your  circular,  I  cannot  say 
that  I  have  ever  seen  a  case  of  tuberculosis  which  it  seemed 
possible  to  trace  to  a  milk  supply  as  a  cause ;  but  I  do  not 
doubt  that  the  milk  supply  may  be  an  important  factor  in  the 
production  of  the  above  disease  in  some  cases. 

Andrew  Baylies,  M.  D. 

13. 

Tckner's  Falls,  Mass.,  February  19, 1890. 
Dear  Doctor,  —  In  answer  to  yours  of  recent  date,  will 
say  have  never  had  a  case  when  it  was  possible  to  prove  it 
due  to  the  milk  supply,  yet  I  firmly  believe  it  was. 

Hastily  yours,  E.  G.  Best. 

14. 

Baebe,  Mass.,  February  10, 1890. 

H.  C.  Ernst,  M.  D. 

Sir,  —  In  answer  to  your  inquiry,  I  would  say,  that  I  have 
never  had  a  case  of  tuberculosis  that  I  could  trace  to  a  milk 
supply.  Several  years  since  there  was  a  cow  in  this  town  that 
evidently  had  tuberculosis,  but  the  milk  or  beef  was  not  used. 
No  post-mortem.  Eespectfully, 

L.  F.  Billings,  M.  D. 

15. 

Sheebobn,  Mass.,  February  8,  1890. 

Dear  Doctor,  —  I  do  not  think  I  ever  had  a  case  of 
tuberculosis  which  I  could  trace  to  a  milk  supply  as  a  cause. 
It  should  be  said,  however,  that  this  is  an  agricultural  town, 
and  a  large  part  of  the  people  make  the  milk  which  they  use 
on  their  own  premises.  I  would  also  add  that  the  percentage 
of  cases  of  that  disease  is  much  smaller  now  in  this  town  than 
it  was  twenty-five  or  thirty  years  ago. 

Yours  truly,         A.  H.  Blanchard,  M.  D. 


INFECTIOUSNESS  OF  MILK.  45 

16.    (^Answer  to  above.') 

Boston,  February  10,  1890. 

My  dear  Doctor,  —  Thank  you  for  your  reply  to  my 
letter  in  regard  to  tuberculosis  and  milk.  May  I  ask  you 
whether  the  diminution  in  your  town  of  the  disease  (tubercu- 
losis) is  a  matter  of  personal  observation  or  of  record  ?  It 
is  an  interesting  fact  to  know.         Very  truly  yours, 

Harold  C.  Ernst. 

A.  H.  BnAjfCHABD,  M.  D.,  Sherborn,  Mass. 

17.  iReply.) 

Sherborn,  Mass.,  February  15,  1890. 

Dear  Doctor,  —  Referring  to  your  letter  of  February 
10th,  in  which  you  ask  whether  the  decline  in  the  number  of 
cases  of  tuberculosis  is  a  matter  of  personal  observation  or 
of  record,  I  reply  that  it  is  both.  It  is  from  personal  obser- 
vation since  1851,  and  from  record  since  1841,  when  the 
cause  of  death  was  first  recorded  in  our  town  register.  For 
about  fifteen  years,  from  1841,  the  cases  of  death  from  that 
disease  were  fully  25  per  cent,  of  the  whole  number  of  deaths. 
Since  that  time  there  has  been  a  gradual  diminution,  until  in 
the  ten  years,  1880-89,  the  rate  has  been  but  8.5  per  cent,  of 
the  total  number.  Those  figures  are  obtained  from  the  town 
record.  I  think  during  the  latter  years  there  has  been  less  of 
overwork  among  farmers  and  their  wives,  and  that  there  has 
been  generally  a  more  careful  observance  of  the  laws  for  the 
preservation  of  health  ;  and  this  may  have  had  something  to 
do  with  the  decrease  in  that  disease. 

Very  truly  yours,         A.  H.  Blanchard. 
H.  C.  Ernst,  M.  D. 

18. 

My  dear  Doctor,  —  Your  circular  duly  received,  and 
evidently  became  mislaid.  Am  not  aware  of  any  case  ever 
coming  rmder  my  observation  which  could  be  consistently 
ascribed  to  milk  supply.    It  would  seem  to  be  a  question  that 


46  INFECTIOUSNESS   OF  MILK. 

ought  to  be  settled,  —  the  possibility  of  infection  from  milk 
supply,  —  and  make  our  precautions  conform  thereto.  Suc- 
cess to  your  labors.  Yours  cordially, 

A.  G.  Blodgett. 

West  Bbookfield,  Mass.,  July  9, 1890. 

19. 

February  6,  1890. 

Dear  Doctor  Ernst,  —  I  have  often  thought  of  the  milk 
supply  as  a  source  of  tuberculous  infection,  and  have  sought 
to  connect  it  with  the  disease,  but  have  not  succeeded  in  so 
doing.  I  am  glad  that  you  are  doing  this  work,  which  is,  in 
my  opinion,  of  great  importance. 

Yours  truly, 

Albert  N.  Blodgett. 
P.  S.  —  I  suppose  you  mean  cow's  milk. 

20.  (^Of  inquiry  to  preceding .^ 

Boston,  February  8,  1890. 
My  dear  Doctor,  —  Thank  you  for  your  reply  to  my 
letter.  Do  you  mean  to  imply  that  you  have  ever  seen  cases 
that  seemed  to  you  to  be  due  to  nursing  a  tuberculous  woman  ? 
If  so,  I  want  all  the  details  that  you  are  inclined  to  give  me, 
if  you  will  be  good  enough  to  send  them  to  me.  The  matter 
seems  to  me  to  be  one  that  requires  immediate  and  thorough 
investigation,  and  I  suppose  that  it  is  needless  to  refer  you  to 
the  experimental  evidence  that  I  have  offered  in  a  recent 
number  of  the  "  American  Journal  of  Medical  Sciences." 

Sincerely  yours,  Harold  C  Ernst. 

21.  {Answer  to  20.) 

Boston,  February  10,  1890. 

Mt  dear  Doctor  Ernst,  —  Yours  of  the  8th  at  hand, 
and  I  am  sure  you  will  pardon  me  for  the  allusion  to  mother's 
milk,  which  I  made  only  because  I  know  of  your  good  work 
in  this  important  direction.     I  have  at  present  no  definite 


INFECTIOUSNESS   OF  MILK.  47 

results  to  communicate,  but  I  have  taken  some  observations 
which  are  not  at  present  in  a  form  to  communicate,  but  which 
I  will  take  the  liberty  to  present  if  they  reach  any  practical 
form.  I  have  followed  your  communications  in  the  "  Amer- 
ican Journal  "  with  much  interest,  and  think  we  all  owe  you 
a  debt  of  gratitude  for  your  painstaking  labors  in  a  direction 
which  presents  peculiar  and  almost  insurmountable  obstacles 
to  the  investigator.  Yours  sincerely, 

Albert  N.  Blodgett. 

22. 
I  think  not,  as  we  have   an   abundant   supply  of   pure 
milk.  J.  M.  Blood. 

AsHBT,  Mass. 

23. 

Newton  Centre,  Pebrnary  11, 1890. 

Dear  Doctor,  —  I  have  never  met  with  a  case  of  tuber- 
culosis that  I  could  directly  trace  to  a  milk  supply. 

Yours,  J.  H.  Bodge. 

24.    (  Of  inquiry  to  preceding.^ 

Boston,  February  14, 1890. 
My  dear  Doctor,  —  In  your  reply  to  my  circular  in 
regard  to  tuberculosis  and  milk,  you  seemed  to  imply  that 
you  had  heard  of  such  a  case  as  was  there  inquired  about. 
If  that  is  so,  will  you  not  be  good  enough  to  send  me  the  ac- 
count of  it,  or  put  me  in  the  way  of  getting  such  an  account  ? 
The  importance  of  the  subject  is  my  excuse  for  intruding 
upon  you  again. 

Very  truly  yours, 

Harold  C.  Ernst. 

Dr.  J.  H.  Bodge. 

No  reply  was  ever  received  to  the  above. 


48  INFECTIOUSNESS   OF  MILK. 

25. 

113  BoYiiSTON  Street,  February  7, 1890. 
Deak  Doctor,  —  I  have  never  seen  a  case  wliicli  I  thought 
attributable  to  milk.     You  are  engaged  in  a  most  important 
work,  and  I  wish  I  could  help  you  more  than  by  a  simple 
negative.  Yours  truly, 

Henry  I.  Bowditch. 

26. 

Dear  Doctor  Ernst,  —  I  have  no  positive  data  bearing 
upon  the  question.  Yours,  W.  P.  Bowers. 

27.  (  Of  inquiry  to  preceding.^ 

Boston,  February  14,  1890. 

Dear  Doctor,  —  Even  if  you  have  no  positive  evidence 
in  regard  to  the  communication  of  tuberculosis  by  the  milk 
supply,  will  you  not  send  me  any  suspicious  cases  that  have 
come  under  your  observation  ? 

Sincerely  yours, 

Harold  C.  Ernst. 

Dr.  W.  F.  Bowers,  CLiNTOiir,  Mass. 
No  reply  received  to  the  above. 

28. 

Lowell,  Mass.,  February  10, 1890. 

Dr.  H.  C.  Ernst. 

Dear  Sir,  —  I  certainly  never  did  see  a  case  as  desig- 
nated. I  lived  and  practiced  over  eight  years  in  and  near 
Montreal,  D.  C,  and  here  over  eight  years  too,  and  I  have 
not  yet  seen  a  case  that  I  could  surely  and  beyond  peradven- 
ture  trace  to  the  milk  supply.  And  yet  I  have  been  a  man 
of  observation  in  that  direction  for  a  purpose. 

Yours  very  truly, 

H.  R.  Brissett,  M.  D. 


INFECTIOUSNESS   OF  MILK.  49 

29.  (  Of  inquiry  to  preceding.') 

Boston,  February  12,  1890. 

My  dear  Doctor,  —  Would  you  be  willing  to  give  me 
any  details  in  regard  to  cases  that  have  come  under  your  ob- 
servation where  you  even  suspected  the  milk  as  a  cause  of  the 
transmission  of  tuberculosis  ?  Any  evidence  is  of  value  in 
such  a  matter  as  this.  Very  truly  yours, 

Harold  C.  Ernst. 

H.  K.  Bkissett,  M.  D.,  Lowell. 

30.  (JRepily  to  preceding .) 

Lowell,  February  25,  1890. 

Dr.  Ernst. 

Dear  Sir,  — I  have  carefully  looked  through  all  notes  that 
I  possess  dating  twenty  years  back,  and  cannot  find  nor  recall 
a  single  case  that  I  could  trace  to  tuberculous  infection  from 
the  cow,  nor  can  I  recall  one  case  of  tuberculosis  that  I  even 
remotely  suspected  was  of  that  origin,  and  so  must  dismiss 
the  question  with  some  sorrow  at  not  being  able  to  shed  some 
light  (faint  even)  on  the  subject,  —  a  most  important  one. 
Yours  very  truly,  H.  K.  Brissett,  M.  D. 

A  note  of  thanks  was  returned  for  the  above. 

31. 

My  dear  Doctor  Ernst,  —  I  have  never  encountered  a 
tuberculous  case  which  seemed  traceable  to  the  lower  animals, 
although  I  deem  such  contagion  quite  possible. 

Very  truly,  W.  E.  Brown,  Gilbertville. 

February  13,  1890. 

32. 
Stoneham,  Mass.,  February  10, 1890. 

Dear  Doctor,  —  I  have  not  met  with  any  case  of  tuber- 
culosis which  could  be  traced  to  a  milk  supply.  Dr.  Clarke, 
of  Melrose,  has  met  with  several  cases,  and  could  furnish  you 
with  particulars.  Respectfully, 

W.  S.  Brown,  M.  D. 


60  INFECTIOUSNESS   OF  MILK. 

A  letter  of  inquiry  to  Dr.  Clarke,  who  had  akeady  sent  a 
negative  to  the  circular,  called  out  the  following  :  — 

33. 

Melrose,  February  15, 1890. 
My  dear  Doctor,  —  Doctor  Brown  is  in  error  when  he 
spoke  of  my  paper,  read  before  the  Society.    It  was  on  Diph- 
theria and  milk  supply.     I  would  be  pleased  to  be  of  service 
to  you.  Yours  very  truly,  J.  S.  Clarke. 

34. 

I  am  unable  to  give  you  any  information  that  would  be  of 
service  to  you.  The  milk  supply  is  not  by  any  means  what 
we  could  wish,  yet  at  the  same  time,  whatever  harm  it  may 
do  is  hard  to  state.  In  all  cases  of  tuberculosis  which  I  have 
observed,  all  conditions  were  such  that  the  source  could  not 
be  told,  and  I  could  not  attribute  to  milk  more  than  other 
foods  or  influences  from  external  conditions. 

Yours,  F.  L.  BuET. 

751  Tkemont  Stbeet,  Boston. 

35. 

"  No,  from  animal  to  man ;  —  yes,  from  animal  to  ani- 
mal." W.  J.  Coates,  M.  D. 

141  W.  54th  Street,  N.  Y. 

36. 
A  letter  of  inquiry  brought  back  the  following :  — 

New  York,  February  21,  1890. 

Dear  Doctor,  —  I  deferred  answering  your  note  on  ac- 
count of  sickness  in  my  family.  The  cases  I  refer  to  were  two 
calves,  from  different  mothers,  which  were  healthy  and  fed  on 
milk  from  a  tuberculous  cow  (Jersey).  I  had  both  cow  and 
calves  destroyed,  and  on  post-mortem  revealed  tubercular  de- 
posits in  lungs  and  other  portions  of  the  body.  One  of  our 
cats  was  fed  with  milk  from  a  cow  suffering  from  tuberculosis, 
and  developed  the  symptoms  of  phthisis,  she  becoming  so  ema- 


INFECTIOUSNESS   OF  MILK.  51 

ciated  and  weak  that  she  was  destroyed  after  a  period  of  eight 
or  nine  months,  and  showed  tubercular  deposits  over  the  en- 
tire body.  Other  cats  were  fed  on  tubercular  milk,  and  some 
developed  the  same.  In  regard  to  the  human  subject,  it  is 
difficult  to  trace,  as  there  is  too  great  a  difference  between 
cause  and  effect ;  by  the  time  the  physician  could  recognize 
the  disease,  the  milk  source  would  be  lost  sight  of.  A  man 
might  be  ailing  for  many  years,  and  his  disease  not  appre- 
ciated by  his  physician,  until  some  day  he  takes  what  is 
commonly  termed  a  cold  and  develops  acute  symptoms  of 
phthisis  which  will  be  given  credit  to  atmospheric  influences 
and  not  to  a  source  of  meat  or  milk  supply  which  may  have 
been  years  before.  The  milk  question  will  probably  not  be 
settled.  Yours,  etc., 

W.  J.  CoATES,  M.  D.,  V.  S. 

A  letter  of  thanks  was  returned  for  the  above. 

37. 

Deak  Sie,  —  I  have  never  seen  a  case  of  tuberculosis 
which  it  seemed  possible  to  me  to  trace  to  the  milk  supply  as 
a  cause.  You  are  not  to  take  this,  however,  as  an  expression 
of  disbelief.  At  present  it  seems  probable  to  me  that  milk 
may  be  a  cause  of  tuberculosis. 

Yours  truly, 

D.  M.  Cammann,  M.  D. 

19  E.  33d  Stkeet,  N.  Y.,  February  8, 1890. 

38. 

920  Market  Street,  San  Francisco, 
February  13,  1890. 

Dear  Doctor,  —  My  answer  to  your  question  is  no.  As 
bearing  on  the  subject  I  may  mention  that  I  have  never  seen 
elsewhere  tubercidosis  so  prevalent  and  deadly  as  it  was  in 
Alaska  during  my  stay  there  —  1865-1872  —  among  the  In- 
dians, who  had  no  milk  except  the  human  variety. 

Geo.  Chismire. 


52  INFECTIOUSNESS  OP  MILK. 

39. 
A  letter  of  inquiry  to  Dr.  Chismire  brought  the  following : 

920  Makket  Street,  San  Francisco, 
March  1,  1890. 

My  dear  Doctor,  —  I  am  sure  I  have  seeu  statements  of 
the  prevalence  of  tuberculosis  among  the  northern  Indians  in 
print,  but  for  my  life  I  cannot  tell  where.  I  would  suggest 
your  writing  to  the  elder  Dr.  Helmican,  of  Victoria,  British 
Columbia ;  he  is  a  most  competent  man,  and  has  had  more 
than  fifty  years'  experience  while  in  the  service  of  the  Hon. 
Hudson's  Bay  Co.  Very  truly  yours, 

Geo.  Chismire. 

A  letter  of  thanks  was  sent,  but  a  note  sent  to  Dr.  Hel- 
mican met  with  no  response. 

40. 

TowNSEND,  Mass.,  March  6, 1890. 
Dear  Doctor,  —  I  had  occasion  as  an  official  of  the  board 
of  health  to  condemn  last  summer  a  cow  with  consumption, 
and  ordered  killed ;  have  seen  no  ill  results  from  the  use  of 
the  milk.  Yours,  L.  G.  Chandler. 

A  request  for  information  of  any  facts  turning  up  in  con- 
nection with  this  case  has  as  yet  met  with  no  response. 

41. 
Very  few  cases  of  tuberculosis  in  this  neighborhood  during 
the  time  I  have  known  it.  C.  A.  Cheever, 

Mattapan,  Mass. 

42. 

65  Chandler  Street,  Boston,  February  10, 1890. 
Dear  Doctor,  —  In  answer  to  your  circular,  I  can  say 
that  I  do  not  think  I  have.     But  I  fully  believe  that  such 


INFECTIOUSNESS   OF  MILK.  63 

transmission  is  possible,  and  think  that  too  much  care  cannot 
be  taken  to  guard  against  such  impure  milk. 

Very  truly,  E.  Chenery. 

43. 

Boston,  February  10,  1890. 
Dear  Doctor,  —  Your   inquiry   received.     I   think   the 
query  a  very  important  one.     My  cases,  however,  have  not 
led  me  to  suspect  milk  as  a  probable  cause,  therefore  to  your 
question  I  must  answer  no.  Very  truly, 

C.  H.  Cobb. 

44. 

KoxBUBY,  February  25, 1890. 

Dr.  Ernst. 

Dear  Sir,  —  In  reply  to  your  circular  letter  will  say  that 
I  saw  a  case  that  seemed  to  me  might  possibly  be  tuberculosis 
in  the  baby  —  no  family  history  of  tuberculosis  —  from  the 
cow's  milk.  The  baby  was  fed  on  a  Jersey  cow's  milk  (un- 
cooked). It  never  prospered,  lost  flesh,  developed  a  bron- 
chitis and  large  belly,  much  swollen.  I  could  not  find 
enlarged  glands,  but  otherwise  it  seemed  like  Tabes  Mesen- 
terica.  In  the  mean  while  the  cow  was  taken  sick  and  died, 
and  the  baby  died  soon  after,  but  another  M.  D.  was  in  at  the 
finish,  and  I  did  not  know  about  it,  to  get  a  post-mortem. 

A.  B.  Coffin. 

A  letter  of  thanks  was  sent  for  the  above. 

45. 

Boston,  February  17,  1890. 

I  have  seen  two  cases,  both  children,  when  it  seemed  possi- 
ble to  believe  the  milk  was  the  primary  cause.  Babcock  ex- 
amined the  milk,  and  as  it  was  much  below  standard,  the 
man  was  arrested.  W.  M.  Conant. 


54  INFECTIOUSNESS   OP  MILK. 

A  request  for  further  information  in  regard  to  these  cases 
was  not  responded  to. 

46. 

Boston,  February  16, 1890. 
Dear  Doctor,  —  It  is  perhaps  a  fact  worth  mentioning 
that  very  few  of  the  children  under  the  care  of  the  Dejjart- 
ment  Outdoor  Poor  succumb  to  diarrhoeal  or  digestive  dis- 
eases.    We  often  receive  marasmic  chiklren. 

Yours,  S.  M.  Crawford. 

47. 
Dear  Doctor,  —  I  do  not  think  that  I  have  met  with  a 
well-substantiated  case  of  tuberculosis  traceable  to  milk. 

Very  truly  yours, 

Edw.  L.  Dueb. 

PniLADEiiPHiA,  1606  Locust  Stkeet, 
February  19,  1890. 

48. 

A  letter  of  inquiry  as  to  whether  Dr.  Duer  had  seen  any 
cases  in  which  he  had  had  reason  to  suspect  such  an  origin  of 
tuberculosis  met  with  no  response. 

49. 

Portland,  Me.,  February  20,  1890. 
My  dear  Doctor,  —  I  have  never  been  able  to  trace  a 
case  of  tuberculosis  to  a  milk  supply,  though  I  have  repeat- 
edly suspected  the  milk.  Yours  very  truly, 

Israel  T.  Dana. 

50. 

Having  written  to  Dr.  Dana  for  any  suspicious  cases  that 
he  might  have,  he  replies  as  follows :  — 


INFECTIOUSNESS   OF  MILK.  55 

Portland,  Me.,  Febmary  20,  1890. 

Dear  Dr.  Ernst,  —  I  am  afraid  in  my  hasty  letter  in 
response  to  your  circular  I  gave  rather  a  wrong  impression. 
It  was  rather  a  general  impression,  taken  from  observation, 
than  any  record  of  individual  eases  to  which  I  referred.  I 
have  had  cases  of  infants  brought  up  on  cow's  milk,  where 
neither  heredity  nor  environment  would  lead  to  the  expecta- 
tion of  tuberculosis,  in  which  tuberculous  symptoms  have  rap- 
idly developed,  with  fatal  terminations.  The  symptoms  have 
oftener  been  abdominal  than  pulmonary.  There  have  been 
frequent  loose,  iU-smelling  dejections  and  general  marasmus. 
The  abdomen  has  been  tumid  and  tender,  sometimes  giving 
to  the  touch  the  sensation,  through  the  attenuated  abdominal 
walls,  of  swollen  mesenteric  glands.  In  some  of  the  cases  the 
most  natural  explanation  of  the  phenomena  present  has 
seemed  to  me  to  be  in  the  line  of  infectious  tubercle-produ- 
cing cow's  milk.  Yours  very  truly, 

Israel  T.  Dana. 
51. 

In  reply  to  a  query  to  that  effect.  Dr.  Dana  says  that  he 
was  not  able  in  any  case  to  "  push  investigations  so  far  as  to 
ascertain  that  the  milk  supply  came  from  a  tuberculous  cow. 

51 «. 
Not  from  cow's  milk.    Have  seen  an  apparently  non-tuber- 
culous baby  (waif)  die,  after  nursing  a  few  months  from  a 
tuberculous  foster-mother,  from  tuberculosis. 

Yours  very  truly,  F.  F.  Doggett. 

A  note  was  sent  to  Dr.  Doggett,  asking  for  details  of  this 
case  with  the  following  result. 

51b. 

805  Broadway,  Boston,  February  11,  1890. 

Dear  Doctor,  —  Yours  of  the  8th  inst.  received  in  regard 
to  case.    The  case  occurred  on  Athens  street  in  District  9  of 


56  INFECTIOUSNESS  OP  MILK. 

Boston  Dispensary  while  I  was  physician  to  that  district. 
The  case  so  impressed  me  at  the  time  that  I  made  notes  of  it, 
but  am  sorry  to  say  that  I  have  been  unable  to  find  them 
after  careful  search.  However,  if  the  few  details  of  the  case 
which  remain  in  my  memory  are  of  any  service  to  you,  you 
are  welcome  to  them.  The  child  was  illegitimate,  —  was 
plump  and  healthy  at  birth,  —  was  deserted  by  its  mother  at 
about  six  weeks  old,  and  died  of  acute  miliary  tuberculosis 
at  about  three  and  a  half  months.  When  the  child  was 
deserted,  the  foster-mother,  who  had  just  lost  her  own  baby, 
having  milk  in  her  breasts  and  pity  in  her  heart,  adopted  the 
waif.  I  saw  the  child  about  six  weeks  after,  when  it  was 
three  months  old.  It  was  then  greatly  emaciated,  with  ascites 
prominent,  much  diarrhoea,  and  signs  of  consolidation  at  both 
apices.  The  foster-mother's  milk  was  thin  and  poor,  but 
quite  abundant.  She  had  well  marked  phthisis,  as  I  noted 
on  my  dispensary  book,  —  the  details  I  know  nothing  about. 
What  her  own  baby  died  of  I  was  unable  to  learn.  The 
reputed  father  of  the  child  was  said  to  be  in  good  health ; 
also  the  mother,  who  was  a  servant  girl,  and  was  working 
when  I  first  saw  the  child.  There  was  no  autopsy.  There 
were  convulsions  toward  the  last. 

The  hygienic  surroundings  were  about  as  bad  as  they  could 
be,  and  it  impressed  me  at  the  time  that,  excluding  the  milk 
as  the  medium  of  infection,  the  sputa,  which  was  abundant 
from  the  woman  and  very  carelessly  disposed  of,  might  well 
be  blamed.  Without  autopsy  it  would  perhaps  have  been 
more  exact  to  say  pulmonary  and  abdominal  tuberculosis 
rather  than  general  tuberculosis. 

Yours  very  truly,  F.  F.  Doggett. 

61c. 
Dr.  J.  R.  Deane  of  Newton  Highlands,  Mass.,  returned 
the  circular  letter,  endorsed  "Yes,"  but  an  appeal  to  him 
(letter-book  p.  281)  for  details  of  the  case,  or  cases,  that  he 
had  seen  received  no  reply. 


INFECTIOUSNESS  OF  MILK.  57 

51  d. 

E.  S.  Dodge  (Natick,  Mass.)  replies,  "  Emphatically,  No." 

52. 

Dear  Doctor,  —  I  must  answer  "  No  "  to  your  query,  but 
as  I,  like  most  physicians,  can  know  so  little  of  the  milk  sup- 
ply of  our  patients  it  seems  to  me  that  negative  testimony  can 
have  very  little  value.  In  fact,  I  do  not  see  how  this  inquiry 
can  lead  to  definite  results  in  cities.  In  the  country,  where 
the  doctor  knows  not  only  the  families  but  often  their  beasts, 
one  might  come  at  positive  results. 

Yours  very  truly,  R.  T.  Edes. 

53. 

Htde  Pabk. 
Dear  Doctor,  —  No,  I  have  not,  except  from  a  tubercular 
mother.  Truly  yours,        C.  L.  Edwards,  M.  D. 

A  letter  of  inquiry  in  regard  to  the  above  received  no 
answer.     It  afterwards  appeared  that  Dr.  Edwards  was  ill. 

54. 

Dear  Dr.  Ernst,  —  Have  never  seen  a  case  which  could 
be  traced  to  milk  with  any  degree  of  probability. 

Very  truly  yours,  E.  P.  Elliot. 

Danters,  February  11, 1890. 

55. 

A  note  asking  for  any  cases  where  suspicion  had  rested 
upon  the  milk  received  the  following  reply. 

Danvers  Lunatic  Hospital,  Danvebs,  Mass., 
February  22,  1890. 

H.  C.  Ernst,  M.  D.,  Boston,  Mass. 
Dear  Sir,  —  Your  letter  of  the  14th,  addressed  to  Dr. 


58  INFECTIOUSNESS   OF   MILK. 

Elliot,  is  received  at  this  hospital.  As  Dr.  Elliot  has  gone  to 
Europe  and  cannot  answer  you  at  once,  I  volunteer  to  make 
the  statement  which  your  letter  seems  to  call  for.  For  a 
period  covering  the  past  five  years  the  ratio  of  deaths  from 
phthisis  to  the  whole  number  of  deaths  in  this  hospital  is 
about  ten  per  cent.  This  is,  I  suppose,  considerably  lower 
than  the  average  ratio  for  the  whole  State.  This  ratio  varies 
but  slightly,  however,  in  the  several  state  hospitals  for  the 
insane,  viz. :  Worcester,  Westboro,  Taunton,  and  South  Bos- 
ton. While  these  hospitals  maintain  a  large  population  of 
chronic  patients  they  are  constantly  receiving  new  cases.  At 
the  Northampton  Hospital,  where  but  a  comparatively  small 
number  of  men  patients  enter,  the  ratio  for  the  same  time, 
the  last  five  years,  is  above  twenty  per  cent. 

We  had  eleven  deaths  from  phthisis  and  one  from  Bright's 
disease  and  phthisis  during  our  last  hospital  year.  Of  these 
twelve  patients,  eight  were  cases  of  chronic  insanity,  three 
were  cases  of  acute  melancholia,  and  one  had  general  paraly- 
sis. I  believe  you  are  engaged  in  a  most  important  study 
and  should  be  glad  to  assist  you  in  establishing  the  facts,  but 
I  cannot  discover  a  "  scrap  of  evidence  "  at  Danvers  that  milk 
causes  tuberculosis.         Very  respectfully, 

Chas.  W.  Page, 
Physician  and  Superintendent. 

A  note  of  thanks  was  returned  for  the  above. 

56. 
I  think  that  I  have,  but  as  it  is  matter  of  opinion  and  not 
of  demonstration,  I  am  unable  to  make  any  observations  upon 
it  that  are  of  any  value.  I  am  very  glad  that  you  have 
started  in  this  work.  I  wish  there  were  some  method  by  which 
I  could  aid  in  it,  for  it  seems  to  me  to  be  very  closely  con- 
nected with  the  public  health.  It  has  been  uppermost  in  my 
mind  for  years,  but  I  did  not  feel  myseK  equal  to  taking  hold 


INFECTIOUSNESS   OF  MILK.  59 

of  it,  and  am  only  too  happy  that  its  importance  is  in  a  fair 
way  of  being  demonstrated. 

Very  truly  yours,  W.  S.  EvERETT. 

Hyde  Park,  February  15,  1890. 

An  appeal  for  details  of  cases  where  the  writer  suspected 
the  milk  supply  as  a  cause  of  tuberculosis  failed  to  meet  with 
a  response. 

57. 

Cincinnati,  February  17, 1890. 
Dear  Sir,  —  I  have  never  seen  a  case  of  tuberculosis  in 
which  a  positive  connection  could  be  established  between  it 
and  tuberculosis  in  the  cow  (milk  supply).  Although  not 
within  scope  of  your  question,  I  am  convinced  of  the  fact 
that  such  connection  does  exist.         Yours  truly, 

F.  FORCHHEIMER. 
Dr.  Harold  C.  Ernst. 

58. 

A  letter  was  sent  to  Dr.  Forchheimer,  asking  if  he  had 
seen  cases  where  the  suspicion  of  the  origin  of  tuberculosis 
from  milk  had  been  aroused  in  his  mind.  This  was  rejjlied 
to  as  follows  :  — 

Cincinnati,  February  19,  1890. 

Dear  Doctor,  —  In  reply  to  yours  of  the  12th,  I  would 
state  as  follows :  according  to  my  notion,  tuberculosis  is  by 
far  the  most  common  of  children's  affections,  —  again,  most 
common  in  a  localized  form.  The  place  where  it  is  most  fre- 
quently found  in  them  is  somewhere  in  the  alimentary  tract 
or  organs  connected  with  it.  Milk  is  the  most  common  arti- 
cle of  diet  in  children  ;  milk  contains  tuberculous  material 
to  an  extent  which,  according  to  my  idea,  is  not  properly 
estimated,  so  that  I  have  the  conviction  that  tuberculosis  is 
frequently  caused  by  milk.  As  to  a  record  of  cases  of  this 
connection,  or  scientific  proof  of  the  same,  I  should  hesitate 
a  very  long  time  before  I  would  put  down  any  individual  case 
as  in  evidence.      Cases  are  not  uncommon,  in  practice,  in 


60  INFECTIOUSNESS   OF   MILK. 

which  a  tuberculous  mother  nurses  an  infant  which  dies,  let 
us  say,  of  a  meningitis  tuberculosa.  Yet,  in  such  a  case,  in 
which  I  am  convinced  that  the  mother  has  transmitted  tuber- 
culosis to  her  child,  how  can  I  present  evidence  sufficiently  con- 
clusive to  prove  that  the  infection  has  not  come  from  another, 
extraneous  source  ?  I  have  seen  children  who,  according  to  the 
statement  made  to  me,  have  had  no  other  food  but  milk,  with 
the  following  set  of  lesions  :  tuberculosis  of  the  glands  about 
the  neck,  of  intestine,  mesenteric  glands,  lungs,  and  meninges. 
I  am  justified,  I  think,  in  the  conclusion  that  the  tuberculo- 
sis was  produced  by  a  something  introduced  into  the  alimen- 
tary canal.  I  am  convinced  that  it  was  by  means  of  milk,  yet 
I  am  not  justified  in  this  individual  case  in  stating  that  this 
was  the  cause  to  my  knowledge.  In  other  words,  I  cannot 
put  down  such  a  case  as  one  capable  of  exact  demonstration. 

I  hope  I  make  my  meaning  clear.  If  such  cases  as  I  have 
referred  to  will  be  of  any  service  to  you,  I  will  be  very  glad 
to  hunt  through  my  records  for  you. 

Very  truly  yours,  F.  Forchheimer. 

Dr.  Hakold  C.  Ernst. 

A  note  of  thanks  was  returned  for  the  above. 

59. 
I  have  never  yet  seen  a  case  of   tuberculosis  that  I  felt 
could  be  laid  to  milk  supply,  unless  it  was  a  mother's  milk. 
I  think  that  our  milk  supply  is  good,  and  from  well-managed 
farms  and  good  healthy  cows.     Respectfully  yours, 

U.  H.  Flagg,  M.  D.,  Mittineague,  Mass. 

A  letter  of  inquiry  for  definite  information  in  regard  to 

any  cases  of  transmission  by  means  of  mother's  milk  failed 

to  call  out  a  response. 

60. 

283  Essex  St.,  Lawrence,  Mass.,  February  8,  1890. 

Dear  Doctor,  —  No,  I  never  did ;  but  the  possibility  of 

tuberculosis  in  the  udder  of  a  cow  being  propagated  to  the 


INFECTIOUSNESS   OF   MILK.  61 

human  race  has  for  the  last  five  years  been  a  source  of  un- 
easiness to  me.  Yours  sincerely, 

F.  B.  Flanders. 

61. 

Ann  Akbor,  Mich.,  February  9, 1890. 
Not  of  tuberculosis,  but  several  of  Tabes  Mesenterica. 

Heneage  Gibbes. 

A  request  was  sent  for  information  in  regard  to  the  cases 
of  Tabes  Mesenterica  spoken  of  above,  and  called  forth  the 
following :  — 

62. 

Univeesitt  of  Michigan,  Pathological  Labokatort, 
Ann  Arbor,  Febraary  17,  1890. 

My  dear  Sir,  —  I  am  under  the  impression  that  your 
views  on  tuberculosis  and  mine  are  opposed.  I  am  now  writ- 
ing a  paper  on  this  subject,  in  which  I  shall  utilize  the  cases 
I  mentioned.  I  think  it  would  not  do  for  the  same  cases  to 
appear  on  opposite  sides  of  the  same  subject,  otherwise  I 
should  have  gladly  sent  you  an  account  of  them.     I  am 

Yours  very  truly, 

Heneage  Gibbes. 

Dr.  Habold  C.  Ernst,  Boston. 

63. 

The  following  reply  was  sent  to  the  above. 

Boston,  February  23, 1890. 

My  dear  Sir,  —  I  regret  that  you  should  feel  that  you 
cannot  send  me  an  account  of  the  cases  that  you  spoke  of.  I 
hope  that  I  am  not  more  stubborn  of  conviction  than  most 
men ;  and  if  I  am  not  easily  moved  by  striking  evidence  I 
am  unconscious  of  the  fact.  I  hope  that  I  shall  see  the  paper 
upon  tuberculosis  when  it  is  published,  and  beg  to  apologize 
for  my  indiscreet  intrusion  upon  you. 

Very  truly  yours,  Harold  C.  Ernst. 

Dr.  Heneage  Gibbes,  Ann  Arbor,  Michigan. 


62  INFECTIOUSNESS   OF  MILK.  I, 

64. 

In  reply  to  the  above  note,  Dr.  Gibbes  writes  as  follows :  — 

Akn  Arbor,  February  25,  1890. 

My  dear  Sir,  —  I  am  afraid  I  expressed  myself  badly  in 
my  last  letter  to  you.  1  have  read  several  of  your  papers,  and 
gather  from  them  that  you  are  convinced  the  tubercle  bacillus 
is  the  cause  of  tuberculosis  ;  from  this  I  conclude  you  consider 
human  and  bovine  tuberculosis  identical.  Now  I  am  not  sat- 
isfied on  these  points,  and  intend  to  use  the  cases  I  have  in 
support  of  my  argument.  Your  circular  and  letter  gave  me 
the  idea  you  were  collecting  evidence  in  support  of  your  views, 
and  I  could  not  give  you  my  facts  for  your  side  of  the  ques- 
tion. Yours  very  truly, 

Heneage  Gibbes. 

To  the  above  no  reply  was  sent,  although  it  might  easily 
have  been  said  that  facts  are  the  same  whichever  side  they 
are  used  upon. 

65. 

Lowell,  March  3,  1890. 

Dear  Doctor  Ernst,  —  The  accompanying  sample  of 
milk  is  from  a  cow  that  has  furnished  milk  to  a  child  now 
suffering  from  meningitis  (whether  tuberculous  or  not  I  am 
not  yet  sure).  I  have  had  the  cow  examined  by  a  veterinary 
surgeon.  He  says  that  the  lungs  sound  rather  suspicious,  but 
the  symptoms  are  not  yet  characteristic.  I  thought  you 
would  be  interested  to  look  over  a  sample  of  "  strippings  "  for 
bacilli.  I  will  let  you  know  the  outcome  of  case. 
Very  sincerely  yours, 

J.  Arthur  Gage,  48  Central  St. 

66. 
Shortly  afterwards  a  second  letter  came  from  Dr.  Gage,  as 
follows :  — 


INFECTIOUSNESS  OF  MILK.  63 

LowELi,,  March  12,  1890. 

Dear  Doctor,  —  I  sent  you  recently  a  specimen  of  milk, 
and  I  write  now  to  tell  you  that  the  child  died  yesterday. 
Although  no  autopsy  was  obtained,  the  symptoms  and  course 
were  sufficiently  distinctive  to  warrant  a  diagnosis  of  tuber- 
cular meningitis.  The  family  history  is  good,  and  the  food 
consisted  (aside  from  breast  milk)  only  of  milk  from  one 
cow.  I  shall  keep  the  cow  under  surveillance,  and  shall  be 
glad  to  hear  whether  you  found  any  bacilli  in  the  milk.  Pro- 
vided you  would  like  another  specimen,  I  will  procure  and 
send  you  one.  Very  sincerely  yours, 

J.  Arthur  Gage. 

Dr.  Hakold  C.  Ebnst. 

67.  (JRejily  to  the  above  letters.^ 

Boston,  March  15, 1890. 
My  dear  Doctor,  —  I  am  in  receipt  of  your  letters,  and 
should  have  answered  them  before  this,  but  that  I  have  been 
overwhelmed  with  work.  I  got  the  specimen  of  milk  all 
right,  and  used  it  for  inoculation  and  cover-glass  experiments. 
If  there  is  any  result  I  shall  be  glad  to  let  you  know ;  in  the 
mean  time  please  accept  my  thanks  for  your  kindness  and  the 
trouble  that  you  have  taken.  Very  sincerely  yours, 

Harold  C.  Ernst. 

J.  Arthub  Gagb,  M.  D.,  Lowell. 

The  result  of  this  inoculation  is  given  in  its  proper  place, 
and  was  the  death  of  three  out  of  four  of  the  rabbits  inocu- 
lated, as  shown  in  the  record  of  experimental  work.  Early 
in  May  a  note  was  sent  to  Dr.  Gage  telling  him  of  the  result 
of  the  inocidations,  and  asking  if  one  of  my  assistants  could 
see  the  cow  if  he  came  to  Lowell.     The  reply  is  below. 

68. 

Lowell,  May  8, 1890. 

Dear  Doctor  Ernst,  —  Your  letter  just  at  hand.  I  reply 
at  once  to  say  that  I  will  fill  out  records  for  you,  and  would 


64  INFECTIOUSNESS   OF  MHJi. 

like  to  have  some  one  come  up  to  look  over  the  cow  with  me. 
I  imderstand  that  another  child  has  been  fed  on  the  same 
cow's  milk,  and  I  will  look  up  the  matter. 

Yours  very  truly,  J.  Arthur  Gage. 

The  records,  as  promised  above,  have  never  come,  and  one 
of  my  assistants  (Dr.  Frothingham)  went  to  Lowell,  and  was 
unable  to  find  any  definite  signs  of  tuberculosis  in  the  sus- 
pected animal. 

69. 

Boston,  February  Y,  1890. 
To  mother's  milk,  yes ;  to  cow's  or  other  domestic  animals, 
no. 

George  W.  Galvin. 

United  States  Hotel. 

A  letter  of  inquiry  was  sent  to  Dr.  Galvin,  with  the  follow- 
ing result :  — 

70. 

Boston,  Febroary  11, 1890. 

H.  C.  Ernst,  M.  D. 

Dear  Sir,  —  The  only  case  to  which  I  can  refer  you  is  at 
13  Edinboro  Street.  Ask  for  Mr.  Clark.  I  have  had  sev- 
eral cases  which,  to  my  mind,  were  tuberculous,  through  the 
mother's  milk.  I  may  be  able  to  furnish  one  more  as  soon  as 
I  ascertain  the  condition  of  the  child.  I  told  Mr.  Clark  to 
expect  you  or  your  assistant.     Very  truly  yours, 

George  W.  Galvin. 

A  letter  of  thanks  for  this  note  was  returned,  and  Dr. 
Jackson  visited  the  family,  sending  in  the  following  note  of 
the  case :  — 

"  A  boy  six  years  old,  —  tuberculous.  Nursed  by  his 
mother,  who,  while  nursing  him,  developed  a  cough,  and  died 
three  years  later  of  pulmonary  tuberculosis." 


INFECTIOUSNESS   OF  MILK.  65 

71. 

Never,  never,  never.  It  may  be  possible,  but  not  probable, 
unless  the  cow  has  been  dissipated,  and  a  free  user  of  alco- 
holic drinks  ! 

T.  Garceau. 

ROXBURY. 

72. 

Spkingfield,  February  8, 1890. 

Dr.  H.  C.  Ernst. 

Dear  Sir,  —  In  answer  to  your  printed  query,  No  !  (I 
understand  your  germ  theory,  with  milk  for  a  vehicle.)  But 
I  have  a  case  of  a  woman  in  my  own  family  who  has  chronic 
tuberculosis,  and  who  had  "  la  grippe,"  followed  by  pneu- 
monia, or  second  stage,  and  who  tooh  no  medicine  but  milk, 
constantly  sipping  it  night  and  day,  according  to  her  whim. 
She  is  able  to  be  about  the  house,  and  is  better  than  before 
the  "  grippe."     She  is  seventy-three  years  old. 

Yours,  W.  W.  Gardner. 

73. 

Gloucester,  February  15, 1890. 

Dear  Doctor,  —  In  answer  to  your  circular  I  would  say 
that  I  have  had  no  case  which  could  be  satisfactorily  traced 
to  a  milk  supply  as  a  cause.         Yours  truly, 

A.  S.  Garland. 

A  note  of  inquiry  in  regard  to  any  cases  where  suspicion 
was  aroused  received  no  reply. 

74. 

QuiNCT,  Mass.,  February  7, 1890. 

Dear  Doctor,  —  A  child  about  ten  months,  bottle-fed, 
developed  tuberculosis  and  died.  The  cow  from  which  the 
milk  was  obtained  died  of  tuberculosis  a  few  weeks  after- 
wards. Yours  very  truly, 

J.  A.  Gordon,  M.  D. 


66  INFECTIOUSNESS   OF  MILK. 

A  request  to  Dr.  Gordon  for  any  further  details  in  regard 
to  the  case  mentioned  above,  brought  this  reply  :  — 

75. 

March  21,  1890. 

My  dear  Doctor  Ernst,  —  In  reply  to  your  note  of 
February  10,  relating  to  the  question  of  tuberculosis  and  the 
milk  supply,  I  am  very  sorry  to  say  that  I  have  no  notes  of 
the  case  I  mentioned,  although  my  memory  serves  me  fairly 
well  as  to  the  main  facts,  which  are  as  follows  :  A  child  of  per- 
fectly healthy  parents,  with  no  hereditary  or  present  history 
of  consumption,  wasted  and  died  with  symptoms  pointing 
unmistakably  to  tuberculous  disease.  After  the  death  of 
the  child  I  ascertained  that  the  cow  which  had  sujDplied  the 
milk,  which  had  been  the  exclusive  diet  of  the  child  for  sev- 
eral months,  had  had  a  cough  for  some  time,  and  died  with 
signs  and  symptoms  of  pidmonary  tuberculosis  a  few  weeks 
afterwards.  Yours  very  truly, 

J.  A.  Gordon. 

A  note  of  thanks  was  returned  to  Dr.  Gordon  for  his  letter. 

15  a. 

Since  the  relation  between  tuberculosis  and  milk  has  been 
under  discussion,  I  have  had  little  or  no  experience  with 
tubercular  disease,  but  my  answer  to  the  question  proposed  is 
No. 

E.  M.  Hodges. 

408  Beacon  Stkeet,  Boston. 

A  letter  of  thanks  was  sent  to  Dr.  Hodges,  with  a  request 
for  any  suspicious  cases  of  tuberculosis  coming  in  infants 
from  nursing  tuberculous  women,  that  he  might  have  seen. 
He  replied  as  follows :  — 


INFECTIOUSNESS   OF  MILK.  67 

75  6. 

408  Bkacon  Street,  February  10,  1890. 
Dear  Doctor  Ernst,  —  I  have  never  had  "  reason  to 
suspect  the  occurrence  of  tuberculosis  in  an  infant  after, 
and  because  of,  nursing  a  tuberculous  mother."  My  experi- 
ence is  small  as  to  families  in  which  there  have  been  children 
of  tuberculous  mothers  whom  I  have  had  for  long  periods 
under  my  care  or  observation.  I  have  always  forbidden  nurs- 
/  ing  where  I  suspected  tuberculosis  in  the  mother.  I  have 
always  scrupulously  stopped  the  nursing  of  babies  by  wet- 
nurses  with  a  cough,  and  have  done  this  on  general  principles, 
which  I  suppose  must  have  led  other  physicians  to  do  the 
same  thing.  Did  you  get  Dr.  Morrill  Wyman's  opinion  on 
the  question  ?  Yours  sincerely, 

K.  M.  Hodges. 

A  note  of  thanks  was  returned  to  Dr.  Hodges  for  his  letter. 

76. 

February  11,  1890. 

Dear  Doctor,  —  I  have  not  seen  personally  a  case  where 
I  thought  tuberculosis  was  traceable  to  milk  supply  as  a 
cause.     Regretting  that  I  am  unable  to  assist  you,  I  am 

Yours  respectfully,  E.  E.  Holt. 

POBTLAND. 

A  note  was  sent  to  Dr.  Holt  asking  for  reference  to  any 
one  who  had  seen  such  a  case,  and  he  kindly  sent  the  follow- 
ing:— 

77. 
Dr.  Geo.  H.  Bailey  wiU  give  you  details  of  cases. 

Upon  writing  to  Dr.  Bailey  for  any  information  he  might  be 
able  and  willing  to  give,  he  replied  by  the  following  letter :  — 


68  INFECTIOUSNESS  OF  MILK 

78. 

Cattle  Commissioner's  Office, 

State  Veterinary  Surgeon, 
Portland,  February  15,  1890. 

My  dear  Doctor,  —  Yours  of  the  eighth  was  received 
during  my  absence  from  home.  In  answer  to  your  inquiry, 
"  If  I  have  ever  seen  a  case  of  tuberculosis  which  it  seemed 
possible  to  me  to  trace  to  milk  supply  as  a  cause,"  I  feel  per- 
fectly warranted  in  answering  "  yes,"  I  have  a  case  now 
under  observation  where,  about  a  year  ago,  I  condemned  a 
tuberculous  cow,  that  proved  upon  post-mortem  to  be  an  ad- 
vanced case  of  pulmonary  tuberculosis.  The  milk  from  this 
cow  was  the  sole  supply  of  the  family  (a  man  and  his  wife), 
and  although  there  is  no  history  in  the  family  of  the  woman 
that  can  possibly  be  traced  to  phthisis,  she  is  in  an  advanced 
stage  of  consumption,  as  I  have  every  reason  to  believe  from 
the  direct  use  of  the  milk  of  the  cow  that  I  condemned.  I 
have  had  another  case  that  closely  approximates  to  the  above, 
but  where  the  history  involves  the  grandparents  of  the  sub- 
ject. I  send  you  my  report  of  1888,  although  I  suppose  the 
subject  treated  on  pages  10,  11,  12,  13  are  perfectly  familiar 
to  you.     I  am  very  truly  yours, 

Geo.  H.  Bailey,  D.  V.  S., 

State  Veterinary  Surgeon. 

A  note  of  thanks  was  returned  to  Dr.  Bailey  for  his  letter 
and  report. 

79. 

Newark,  N.  J.,  February  7, 1890. 

Dear  Sir,  —  Have  always  believed  in  the  infectious  char- 
acter of  tuberculosis,  and  published  a  pamphlet  and  article  in 
the  "  American  Journal  of  the  Medical  Sciences  "  some  years 
before  Koch's  discovery,  and  while  I  believe  that  milk  from 
a  tuberculous  cow  might  infect,  have  never  yet  been  able  to 
demonstrate  it.  Yours  truly, 

Edgar  Holden,  M.  D. 


INFECTIOUSNESS  OF  MILK.  69 

A  letter  of  thanks,  witli  a  request  for  a  reference  to  his 
paper,  was  sent  to  Dr.  Holden,  but  there  was  no  reply. 

80. 

2.  7.  '90. 
No,  I  never  have.  I  remember  that  Crookshank  showed 
me  a  large  tuberculous  cow's  udder  at  his  laboratory  at 
King's  College,  London,  in  June,  '88,  but  cannot  remember 
whether  the  milk  had  caused  human  tuberculosis  or  not,"  I 
think  it  had.-     Could  you  not  write  to  him  ? 

H.  A.  Hare,  Philadelphia. 

In  accordance  with  the  suggestion,  a  note  was  sent  to  Dr. 
Crookshank,  and  the  following  note  was  received  from  him. 

81. 

King's  College,  London,  March  20, 1890. 
Dear  Sir,  —  I  have  just  returned  from  Egypt,  and  hasten 
to  reply  to  your  letter.  I  have  not  seen  a  case.  I  send  you 
a  copy  of  my  report  (Local  Government  Board),  in  which 
you  will  find  information  bearing  upon  this  important  sub- 
ject. Yours  very  truly, 

Edgar  M.  Crookshank. 

Harold  C.  Ernst,  Esq. 

Thanks  were  returned  for  this  note,  and  for  the  report, 
which  will  be  found  mentioned  in  its  proper  place. 

82. 

PhTLADELPHLA.  HOSPITAI,. 

Dear  Doctor,  —  I  know  of  no  case  of  tuberculosis  trace- 
able to  infected  milk.  It  seems  to  me  that  very  exceptional 
opportunities  for  observation  would  be  needed  to  enable  one 
to  detect  such  an  origin  of  phthisis.        Yours  truly, 

F.  P.  Henry. 

Philadelphia,  February  7, 1890. 
1635  Locust  Street. 


70  INFECTIOUSNESS  OF  MILK. 

83. 

Dear  Sir, — Only  one  case  where  it  seemed  possible  to 
connect  tuberculosis  with  a  milk  supply,  —  and  this  not  con- 
clusive. Yours,  etc.,  W.  L.  Hall. 

A  letter  of  inquiry  for  data  in  regard  to  this  case  failed  to 
receive  a  reply  from  Dr.  Hall. 

84. 

No,  though  we  have  tuberculous  cows  in  many  of  our 
dairies.  Have  seen  cases  of  tuberculosis  which  could  only 
be  caused  by  infection  from  some  source.  If  you  have  not 
done  so,  would  suggest  that  you  write  to  Dr.  A.  H.  Rose, 
U.  S.  Veterinary  Surgeon,  at  Littleton,  Mass. 
I  am  yours  truly, 

Benj.  H.  Haetwell. 

Ayer,  Mass.,  February  7, 1890. 

84  o. 

Palmer,  Febniary  7, 1890. 
Dear  Doctor,  —  No,  I  never  have,  and  have  never  looked 
for  anything  of  the  kind,  my  especial  attention  never  having 
been  directed  that  way  until  my  investigation  of  tuberculosis, 
etc.,  for  material  for  paper  read  by  me  on  Wednesday  in 
Boston.     I  shall  look  out  from  this  time. 

Yours,  Wm.  Holbrook,  M.  D. 

85. 

Htannis,  Mass.,  February  8, 1890. 

Harold  C.  Ernst,  M.  D. 

Dear  Sir,  —  Have  not  had  a  case  traceable  to  the  milk 
supply,  though  I  have  suspected  it. 

E.  E.  Hawes,  M.  D. 

A  letter  of  inquiry  about  cases  where  such  an  origin  of  the 
disease  was  suspected  received  no  reply. 


INFECTIOUSNESS   OF   MILK.  71 

85  a. 
Yes,  one  case.  Yours  truly,  C.  M.  Hulbert. 

South  Dennis,  February  7,  1890. 

Of  course  a  letter  was  sent  to  Dr.  Hulbert  asking  for  de- 
tails of  this  one  case,  but  no  reply  was  ever  received. 

85  6. 
Dr.  Ernst. 

Dear  Sir,  —  Several  suspicious  cases  have  come  under 
my  observation,  but  opportunities  for  a  full  investigation  were 
not  afforded  me ;  therefore  I  am  not  sufficiently  certain  to  be 
sure.  Yours  truly,  W.  H.  Hull, 

85  c. 

Newtonvtlle,  Mass.,  February  8,  1890. 

Dr.  Ernst. 

Dear  Sir,  —  Have  never  seen  a  case  of  tuberculosis  that  I 
could  trace  to  a  milk  supply  as  a  cause,  and  have  never  seen 
any  evidence  that  tuberculosis  could  be  communicated  by 
contagion.  Very  truly  yours, 

Otis  E.  Hunt,  M.  D. 

85  d 
Dr.  E.  D.  Hutchinson,  Westfield,  Mass.,  writes,   "  After 
an  active  practice  of  fifteen  years,  most  decidedly  no." 

86. 

88  Charles  Street,  February  7, 1890. 
Dear  Doctor,  —  I  regret  I  have  no  new  statistics  on  the 
subject,  yet  from  several  cases  I  had  become  suspicious  that 
tuberculosis  originated  in  the  child  from  nursing,  and  there- 
fore have  for  a  long  time  insisted  that  where  the  mother  was 
suffering  from  tuberculous  disease  that  the  infant  should  be 
reared  "  by  hand."  Very  truly  yours, 

Chas.  E.  Inches,  M.  D. 


72  INFECTIOUSNESS   OF  MILK. 

A  letter  asking  for  more  exact  details  from  Dr.  Inches 
called  out  the  following  reply :  — 

87. 

88  Charles  Street,  February  13,  1890. 
Dear  Doctor,  —  I  am  sorry  I  can  give  you  only  my  sus- 
picions, and  the  consequent  prohibition  of  nursing  by  tuber- 
culous mothers.  Of  course  it  is  probable  that  the  tubercu- 
lar disease  in  the  infant  may  be  hereditary,  and  not  due  to 
bacilli  in  the  mother's  milk.  I  have  no  records  on  the  sub- 
ject. Very  truly  yours, 

Chas.  E.  Inches,  M.  D. 

Thanks  were  sent  to  Dr.  Inches  for  the  above. 


My  dear  Doctor,  —  In  reply  to  your  circular  letter  I 
beg  to  say  that  while  I  do  not  know  that  the  milk  supply  has 
been  the  cause  of  tuberculosis  that  has  fallen  under  my  care, 
neither  do  I  know  to  the  contrary.  The  bulk  of  our  milk 
supply  comes  from  a  great  distance  and  it  would  be  difficult 
to  trace  a  suspected  milk  to  its  source.  Regretting  that  I 
cannot  help  you,  believe  me 

Most  truly  yours, 

Chas.  Jenrett,  Brooklyn. 

89. 

Dear  Sir,  —  I  have  no  facts  that  I  could  prove,  but  that 
one  cannot  expect  from  those  who  practice  in  large  cities, 
where  the  source  of  the  milk  cannot  be  traced. 

Very  truly,  A.  Jacobi. 

A  request  for  any  cases  where  suspicion  was  aroused 
received  no  reply  from  Dr.  Jacobi. 


INFECTIOUSNESS   OF  MILK.  73 

89  «. 

My  dear  Doctor,  —  In  replying  in  the  negative  to  your 
question,  I  desire  to  express  my  great  interest  in  the  subject 
which  is  engaging  your  attention.  While  firnily  convinced 
that  many  cases  of  tuberculosis  in  children  which  I  see,  have 
their  origin  in  infected  milk,  such  a  genesis  is  exceedingly 
difficult  to  demonstrate  in  a  great  city,  with  its  milk  supply 
drawn  from  so  many  sources.  I  have  had  some  unpleasant 
experience  with  the  prevalence  of  the  disease  in  even  the  most 
carefully  selected  herds.  Suspecting  its  presence  in  my 
brother-in-law's  herd,  the  opinion  was  confirmed  by  killing 
the  entire  herd  (11),  and  finding  on  autojjsy,  tuberculosis, 
in  every  degree  of  severity,  in  all  its  members.     I  am 

Yours  very  truly,  Francis  P.  Kinnicutt. 

42  W.  27th  St.,  N.  Y. 

A  note  of  thanks  was  sent  to  Dr.  Kinnicutt  for  his  letter. 

90. 

Beixevtie,  Florida,  February  10, 1890. 

H.  C.  Ernst,  M.  D. 

Dear  Sir,  —  Your  inquiry  at  hand.  I  have  never  seen  in 
my  practice  a  case  of  tuberculosis  that  I  thought  I  could  trace 
to  the  milk  supply,  but  I  believe  that  such  cases  do  occur. 

Yours,  C.  H.  Knight. 

90  a. 

Cheraw,  S.  C,  February  18,  1890. 

Harold  C.  Ernst,  M.  D. 

Dear  Doctor,  —  Your  letter  in  reference  to  tuberculosis 
which  it  seemed  possible  to  trace  to  a  milk  supply  as  a  cause, 
has  been  received.  In  reply  I  beg  to  be  allowed  to  report 
briefly  the  following  case  that  came  under  my  observation. 
On  the  tenth  of  April,  1869,  Mrs.  A.  J.  L.,  a  strong  healthy 
woman,  in  the  higher  walks  of  life,  aged  22  years,  gave  birth 
to  a  strong,  vigorous  male  child,  weighing  ten  and  one  half 


74  LNFECTIOUSNESS   OF  MILK. 

pounds.  This  lady  had  always  enjoyed  excellent  health,  and 
there  was  never  a  single  case  of  pulmonary  disease  known 
among  her  ancestors,  on  both  sides  for  three  generations. 
They  were  all  long-lived  people.  She  was  very  ill  after  her 
confinement,  partly  from  some  neglect  or  mismanagement 
during  her  lying-in,  and  never  nursed  her  child  a  single 
time.  I  saw  her  in  consiiltation  on  the  eighteenth  of  April, 
eight  days  after  her  accouchement,  and  found  her  in  a  de- 
plorable condition.  .  .  .  She  died  the  next  night,  —  nineteenth 
of  April. 

Mrs.  E.  C.  W.,  aged  nineteen  years,  gave  birth  to  a  dead 
infant  on  the  eighth  of  April,  two  days  prior  to  Mrs.  A.  J.  L.'s 
confinement.  Having  an  abmidant  supply  of  milk,  Mrs.  R. 
C.  W.  offered  to  nurse  the  child  of  her  friend  and  near 
neighbor.  I  remonstrated  against  this,  but  with  no  effect. 
Mrs.  R.  C.  W.  was  well  advanced  in  puhnonary  consumption. 
This  I  know  positively,  for  I  had  examined  her  lungs,  and 
prescribed  for  her  from  time  to  time.  Both  parents  and  two 
or  three  brothers  of  Mrs.  E..  C.  W.  had  died  of  pulmonary 
disease.  At  the  age  of  twenty  months,  this  vigorous  child  of 
Mrs.  A.  J.  L.  began  to  pine  and  show  signs  of  a  want  of  thrift 
and  vigor.  At  this  age  it  had  a  troublesome  cough,  which 
continued  with  more  or  less  severity  till  ten  or  eleven,  when 
it  had  a  hemorrhage.  It  had  several  hemorrhages  and  died 
in  its  fourteenth  year.  I  made  an  autopsy  of  the  child  and 
found  both  lungs  riddled  with  tuberculous  deposits.  Mrs.  R. 
C.  W.  died  when  twenty-four  years  of  age.  I  made  an 
autopsy  of  her  case,  and  found  her  lungs  in  a  similar  condi- 
tion to  those  of  her  foster-child. 

I  pronounced  this  an  undoubted  case  of  tuberculosis  being 
transmitted  through  the  milk  of  the  woman  who  nursed  the 
child.  ...  If  these  facts  I  have  stated  will  be  of  any  service 
to  you,  I  shall  be  glad  to  know  that  I  have  aided  you  in  your 
laudable  work.  If  I  can  serve  you  further,  please  command 
me.  Very  truly  yours, 

Cornelius  Kollock,  M.  D. 


INFECTIOUSNESS   OF  MILK.  75 

A  letter  of  thanks  was  sent  to  Dr.  Kollock  for  his  interest- 

inff  letter. 
^  91. 

402  Washington  Ave.,  March  6,  1890. 
.  .  .In  reply  to  your  question  I  would  say  that  I  have 
never  seen  myself  a  case  of  tuberculosis  directly  traceable  to 
milk  supply.  Truly  yours, 

Paul  H.  Ketzshmar,  Brooklyn. 

916. 

Yes,  but  not  with  scientific  accuracy.  There  were  three 
cases  which  came  under  my  care  from  another.  All  died. 
No  other  cause  tenable.         J.  A.  Kite,  Nantucket,  Mass. 

A  letter  to  Dr.  Kite  asking  for  further  details  of  these 
cases  was  not  replied  to  in  any  way. 

92. 
Dr.  G.  King  (Franklin,  Mass.)  writes  :  Never  had  any  rea- 
son to  think  that  milk  was  the  cause,  in  the  remotest  degree, 
of  tuberculosis. 

93. 

Dear  Sir,  —  In  reply  to  your  inquiry  as  to  the  causation 
of  tuberculosis  by  milk,  I  would  reply  that  I  have  never  seen 
a  case  in  which  I  have  traced  the  connection.  My  practice, 
however,  is  a  special  one,  and  it  is  a  rare  thing  for  me  to  see 
these  diseases  at  all.  I  see  with  great  pleasure  that  you  are 
interesting  yourself  in  this  important  inquiry. 

Yours  very  truly,  Benjamin  Lee. 

A  letter  of  thanks  was  returned  to  Dr.  Lee  for  his  expres- 
sion of  interest. 

94. 

To  Harold  C.  Ernst,  M.  D. 

I  have  never  seen  a  case  of  tuberculosis  with  any  proof  that 
it  was  due  to  food  conveyance,  nor  in  which  it  seemed  possi- 


76  INFECTIOUSNESS   OF  MILK. 

ble  to  trace  to  milk  supply,  —  the  best  of  all  foods  for  those 
liable  to  phthisis.  EespectfuUy, 

J.  K.  Leaming,  M.  D., 

18  West  38th  Street,  N.  Y. 

95. 

Philadelphia,  February  19, 1890. 
I  am  not  aware  that  I  have  ever  seen  a  case  of  tuberculosis 
traceable  to  a  milk  supply  as  a  cause.    Of  course  this  inquiry 
does  not  apply  to  a  want  of  sufficient  supply  of  milk  to  the 
infant,  which  is  no  doubt  a  frequent  cause  of  disease. 

James  J.  Levick. 
96. 

Conway,  February  1, 1890. 
Dear  Sir,  —  I  have  not,  but  am  on  the  watch,  as  two  of 
our  farmers  have  tuberculosis  in  their  barns. 

Yours  truly. 

Dr.  J.  B.  Laidley. 

A  letter  of  thanks  and  request  for  any  further  information 
that  might  arise  was  sent  to  Dr.  Laidley. 

97. 

Dear  Doctor,  —  I  have  never  been  able  to  trace  a  case 
of  tuberculosis  directly  to  the  milk  supply.  It  may  be  of 
some  interest  to  you  to  know  of  a  man  that  kept  a  cow  within 
the  city  limits.  She  was  tuberculous ;  gradually  lost  flesh 
until  she  was  little  else  than  skin  and  bones.  Being  fed  on 
"  brewers'  grains,"  her  milk  was  sufficient  for  two  families. 
In  one  family  there  were  two  adult  sons ;  both  took  this  milk, 
both  became  sick,  one  or  both  are  dead  of  consumption. 
Others  saw  the  cow  and  would  not  take  her  milk ;  of  these 
none  were  iU.  Yours  truly, 

Henry  F.  Leonard. 

781  Tkemont  Street,  Boston, 
February  7, 1890. 


INFECTIOUSNESS  OF  MILK.  77 

A  request  for  further  information  received  the  following 

reply :  — 

98. 

781  Tremont  Street,  February  11,  1890. 
Dear  Doctor,  —  Yours  received.  I  regret  to  say  I  can 
write  nothing  more  definite  than  you  learned  by  the  postal- 
card.  My  patient,  the  observer  and  informer,  is  now  in  Cal- 
ifornia. The  two  consumptives  are  dead,  and  probably  the 
cow  also.  I  read  with  interest  the  articles  you  refer  to.  If 
possible  to  learn  more  of  this  case  I  will  send  you  word  later. 
Yours  sincerely,  Henry  F.  Leonard. 

99. 

Haverhill,  February  17, 1890. 
Dear  Doctor,  —  I  don't  think  I  quite  understand  what 
you  mean  by  "  a  milk  supply."     If  you  mean  a  milk  diet,  I 
think  I  have ;  if  you  mean  something  else,  I  don't  know. 
Respectfully, 

Oliver  S.  Lovejot,  M.  D. 

A  letter  of  inquiry  and  explanation  was  sent  to  Dr.  Love- 
joy,  but  did  not  elicit  a  response. 

100. 

Newton  Highlands,  February  8, 1890. 
In  answer  to  your  inquiry,  I  have  seen  no  case  of  tubercu- 
losis where  it  was  evident  that  a  milk  supply  was  the  cause. 

J.  D.  LOVERING,   M.   D. 

A  letter  asking  for  suspicious  cases  received  no  reply. 

101. 

Dear  Doctor,  —  A  case   of  the  kind  has  never  come 
under  my  personal  observation. 
Truly, 
-     P.  A.  Morrow, 

66  West  40th  Street,  New  York. 


78  INFECTIOUSNESS   OF  MILK. 

A  request  for  information  concerning  any  cases  occurring 

to  others  which  Dr.  Morrow  might  have  heard  of,  received  no 

reply, 
^^  102. 

Pheladeuphia,  Pa.,  1417  Walnut  Street, 
February  10,  1890. 

Dear  Doctor,  —  I  know  of  no  case  of  tuberculosis  caused 
by  the  use  of  cow's  milk  in  my  individual  experience. 

Yours  truly,  Alex.  W.  Maccoy. 

A  letter  asking  for  any  information  of  cases  heard  of  was 

not  replied  to. 

103. 

Dear  Doctor,  —  In  answer  to  your  circular  note  in  re- 
gard to  the  transmission  of  tuberculosis  from  cow  to  man,  I 
would  say  that  I  have  never  seen  a  case  in  which  such  trans- 
mission could  be  demonstrated  beyond  the  possibility  of 
doubt.  Yours  very  truly, 

John  W.  Mackenzie. 

February  17,  1890. 

A  request  for  information  of  any  cases  where  suspicion  was 
aroused  of  the  causation  of  the  disease  by  milk  received  this 
reply :  — 

104. 

605  North  Charles  Street,  March  3, 1890. 

Dear  Doctor  Ernst,  —  I  would  have  answered  your 
note  sooner,  but  have  been  away  from  home  and  have  not  had 
the  opportunity  to  do  so.  I  am  afraid  that  I  misled  you  in 
my  postal.  The  data,  if  such  a  term  can  be  applied  to  them, 
in  my  possession  are  absolutely  valueless  in  evidence,  and  I 
must  therefore  say  that  I  have  never  seen  a  case  in  which 
there  was  reason  to  believe  that  the  disease  had  been  trans- 
mitted from  one  of  the  lower  animals.  Wishing  you  success 
in  your  researches,  Very  sincerely  yours, 

John  W.  Mackenzie. 


INFECTIOUSNESS  OF  MILK.  79 

105. 

Dear  Doctor,  —  I  regret  that  I  cannot  give  you  any  def- 
inite information  from  my  experience.  I  have  seen  cases 
that  might  have  come  from  milk  supply,  but  under  the  pres- 
ent system  of  obtaining  milk  it  would  be  impossible  to  prove 
anything.  Yours  truly, 

R.  C.  Macdonald,  M.  D. 

106. 

Turner's  Falls,  Mass.,  February  10, 1890. 

Dr.  H.  C.  Ernst. 

Dear  Sir,  —  Would  say  in  reply  to  your  inquiry  that  I 
have  never  known  personally  a  case  of  tuberculosis  traceable 
to  a  milk  supply.  Very  truly  yours, 

C.  C.  Messer. 

A  letter  asking  for  any  cases  where  the  suspicion  had  been 
aroused  in  the  minds  of  others,  and  which  Dr.  Messer  had 
heard  of,  received  the  following  reply  :  — 

107. 
Turner's  Falls,  Mass.,  Febrnary  19, 1890. 

Harold  C.  Ernst,  M.  D. 

My  dear  Sir,  —  Am  sorry  to  say  that  my  reply  to  your 
inquiry  in  regard  to  tuberculosis  in  milk  evidently  implied 
more  than  I  intended.  Have  no  definite  knowledge  upon  the 
subject,  only  the  general  impression  that  it  is  so,  obtained 
from  reading  and  conversation.  Wish  that  I  could  help  you 
to  some  points  upon  the  subject. 

Very  truly  yours,  C.  C.  Messer. 

108. 

Holtoke,  Febmary  13,  1890. 
Dear  Sir,  —  In  answer  to  your  inquiry  I  must  say  that  I 
never  did  see  a  case  of  tuberculosis  which  could  be  traced  to 
milk,  and  I  suppose  I  never  will,  for  the  question  in  the 


80  INFECTIOUSNESS   OF  MILK. 

present  status  of  our  knowledge  can  no  more  be  demonstrated 
than  the  presence  of  Connecticut  River  water  in  the  middle 
of  the  Atlantic  Ocean. 

Respectfully  yours, 

W.   W.   MiTIVIEE. 

To  the  above  the  following  answer  was  returned :  — 

109. 

Boston,  February  16,  1890. 
Sir,  —  I  am  obliged  to  you  for  your  answer  to  my  circular 
letter  in  regard  to  tubercidosis  and  milk,  and  regret  that  it 
does  not  meet  with  your  approval.  Permit  me  to  remind  you 
that  no  advance  would  ever  be  made  in  scientific  subjects  if 
one  shoidd  hesitate  to  undertake  the  investigation  of  subjects 
as  recondite  even  as  the  search  for  the  waters  of  the  Connect- 
icut in  the  middle  of  the  Atlantic  Ocean. 

Very  truly  yours,  Harold  C.  Ernst. 

110. 

212  No.  Matn  St.,  Providence,  February  10, 1890. 

Dr.  H.  C.  Ernst. 

Dear  Sir,  —  Have  never  seen  a  case  of  tuberculosis  which 
could  even  approximately  be  traced  to  milk.  It  has  fallen  to 
my  lot  in  the  last  three  years  to  watch  to  a  termination  sev- 
eral cases  of  phthisis  in  the  same  family  in  which  there  seemed 
to  be  little  doubt  that  each  case  in  succession  was  an  instance 
of  contagion  occurring  in  persons  whose  respiratory  organs 
furnished  a  favorable  soil.  The  second  case  occurred  in  a 
man  who  had,  just  previous  to  the  contagion,  passed  a  most 
searching  examination  when  applying  for  insurance  in  the 
Mutual  Life  of  New  York.  Yours  truly, 

W.  L.  MUNRO. 

A  note  of  inquiry  sent  in  regard  to  the  cases  spoken  of 
above  was  replied  to  as  follows :  — 


INFECTIOUSNESS  OF  MILK.  81 

111. 

212  No.  Main  St.,  Providence,  February  20,  1890. 

Dr.  H.  C.  Ernst. 

Dear  Sir,  —  Yours  of  the  14th  inst.  at  hand.    The  partic- 
ulars of  the  cases  of  which  I  spoke  were  as  follows,  as  nearly 

as  I  can  give  them  just  now.     Amy,  wife  of  Dr.  W.  W , 

of  New  York,  returned  to  this  country  after  several  years' 
residence  in  Europe,  about  October,  1886,  in  an  advanced 
phthisical  condition.  Her  father  and  mother  are  living  at  an 
advanced  age.  No  deaths  from  phthisis  in  immediate  fam- 
ily.    Tall,  thin,  narrow-chested,  and  general  phthisical  aspect. 

Kesided  here  mostly  with  her  brother-in-law,  A.  H.  A . 

Inhabited  same  rooms  as  rest  of  family,  no  attempt  at  quar- 
antine being  made.  Expectoration  moist  and  abundant,  gen- 
erally received  in  an  open  cup,  not  disinfected.  Whole  house 
kept  habitually  at  a  temperature  of  80  F.  or  over.  Died  in 
March,  1887.  A.  H.  A ,  similar  physique,  family  his- 
tory fair,  passed  a  careful  examination  for  life  insurance  for 
a  large  sura  in  Mutual  Life,  about  1885  or  1886.     Never 

rugged,  but  very  seldom  sick.     Shortly  after  Mrs.  W 's 

death  began  to  show  symptoms  (never  correctly  interpreted 
by  his  then  attending  physician).  By  July  4th  had  marked 
cough,  with  expectoration  ;  unable  to  attend  steadily  to  busi- 
ness. Ran  through  all  of  the  stages,  symptoms  developing 
somewhat  slowly,  and  died  March,  1889,  having  been  prac- 
tically bed-ridden  for  six  months.     Mary  N,  A ,  wife  of 

preceding,  and  sister  of  A.  W ;  same  build,  intellectual, 

but  of  highly  excitable  nervous  organization,  with  a  decided 
tendency  to  hysteria;  was  constantly  with  her  sister;  slept 
with  her  husband  until  September,  1888,  about  six  months 
before  his  death  ;  cared  for  him  throughout.  About  Septem- 
ber, 1888,  developed  a  slight,  persistent  cough.  Examination 
of  chest  showed  process  already  active.  Progressed  during 
winter  and  spring.  From  June  to  September,  1889,  was  away 
mland.  Returned  saying  she  had  been  perfectly  well  during 
summer.     Physical  examination  showed  a  rapid  advance  of 


82  INFECTIOUSNESS   OF  MILK. 

the  disease,  however.  While  laying  plans  for  a  winter  in 
Colorado,  her  little  girl  was  taken  sick  with  typhoid.     Before 

her  convalescence,  Mrs.  A was  herself  taken  sick,  had  a 

two  weeks  run  of  fever  of  moderate  severity,  followed  by  two 
exceedingly  severe  relapses  of  two  weeks'  duration.  During 
the  existence  of  typhoid  symptoms,  cough  and  expectoration 
disappeared,  and  no  rales  were  heard.  Period  of  convales- 
cence ushered  in  as  usual,  but  hectic  supervened  directly  upon 
subsidence  of  typhoid  fever ;  phthisical  symptoms  returned 
with  redoubled  force  ;  patient  never  left  bed,  wasted  rapidly, 

and  died  January  21,  1890.     Amy  A ,  child  of  A 

and  M ,  six  years  old,  slept  with  her  mother  for  four 

months  before  being  taken  sick  with  typhoid.  During  fever 
had  considerable  cough,  and  moist  rales  were  heard.  Signs 
now  negative  (takes  cold  very  easily),  but  if  any  lesion  exists 
it  is  quiescent. 

If  above  notes  should  be  of  sufficient  interest,  I  can  with- 
out much  difficulty  procure  more  accurate  data  in  many  direc- 
tions, e.  g.,  remote  family  history. 

Very  truly  yours,  W.  L.  Muneo,  M.  D. 

A  note  of  thanks  was  returned  to  Dr.  Munro  for  the  letter 

given  above. 

112. 

While  believing  for  many  years  that  our  milk  supply  might 
be  a  prominent  factor  in  the  dissemination  of  tuberculosis,  I 
have  never  found  an  opportunity  for  demonstrating  such  a 
relationship.  AnTHUR  H.  Nichols. 

55  Mt.  Vernon  St.,  February  Y,  1890. 

113. 

RocKPORT,  Mass.,  February  10, 1890. 
Have  never  seen  a  case  from  which  I  could  wholly  exclude 
contagion  (personal),  heredity,  and  the  evils  of  moist  and 
otherwise  bad  location.  But  have  seen  several,  two  in  partic- 
ular, in  which  I  strongly  believed  the  cause  might  be  foimd 
in  the  milk  of  tuberculous  cows. 

Kespectfully,  O.  H.  O'Brien,  M.  D. 


INFECTIOUSNESS   OF  MILK.  83 

A  letter  of  inquiry  was  sent  to  Dr.  O'Brien,  asking  for  any 
details  he  could  give  in  regard  to  the  cases  spoken  of  above. 
The  answer  received  was  as  follows :  — 

114. 

KocKPORT,  Mass.,  February  14,  1890. 
Dear  Sir,  —  In  reply  to  your  favor  of  the  14th,  current, 
in  which  you  ask  for  details  of  two  cases  of  tuberculosis  whose 
cause,  as  I  thought,  might  have  been  found  in  the  milk  of 
affected  cows,  I  can  only  give  the  facts  as  I  remember  them 
after  the  lapse  of  more  than  fifteen  years.  Although  on  re- 
call they  seem  trifling  and  altogether  inconclusive,  I  will  state 
them  as  weU  as  I  can,  and  you  may  attach  what  weight  you 
think  proper  to  them. 

1.  Mr.  J.  G ,  aged  thirty-three  years,  family  history 

good,  no  phthisis  as  far  as  I  could  discover,  both  parents  liv- 
ing in  healthy  old  age,  moved  with  wife  and  three  children  to 
a  new  location.  Tenement  near  a  fish  wharf  ;  lot  in  front  of 
house  a  rocky  swamp.  He  was  poor,  and  the  family  were  ill- 
provided.  He  and  his  wife,  soon  after  change  of  residence, 
sickened  and  died  of  phthisis,  very  acute  in  both  cases. 

2.  Mr.  de  G ,  a  French  West-Indian  by  birth,  family 

history  miknown,  had  lived  in  a  house  a  few  rods  from  the 
former,  with  the  same  accidents  of  surroundings,  for  sixteen 
years.  Soon  after  the  death  of  No.  1,  this  man  took  ill  with 
pulmonary  consumption,  and  died  after  a  brief  course  of  the 
complaint.  Two  daughters,  fair  and  plump  girls,  ages  about 
sixteen  and  nineteen,  sickened  and  died  soon  after  from  the 
same  disease.  Now  I  learned  that  both  these  families  had 
been  using  the  milk  obtained  from  the  same  cow.  This  cow 
had  the  reputation  of  being  an  extraordinary  "  good  milker." 
I  often  saw  the  cow.  She  was  poor  as  a  cow  could  well  be  ; 
looked  starved  and  sick,  although  I  knew  that  she  was  weU- 
led.  At  the  time  I  asked  myself  the  question,  was  the  milk 
the  vehicle  of  tuberculous  disease  ?  From  these  meagre  data 
I  was,  and  am  of  course,  unable  to  answer  it,  at  least  affirma- 


84  INFECTIOUSNESS   OF  MILK. 

tively.  All  I  can  say  is,  that  there  appeared  to  be  some 
grounds  for  such  a  suspicion.  It  is  fair  to  add  that  two,  I 
think  three,  deaths,  occurred  soon  after  (within  four  years) 
in  the  same  near  neighborhood,  when  the  milk  of  the  cow  in 
question  could  not  have  been  the  cause.  I  am  firmly  per- 
suaded that  tuberculosis  (phthisis)  is  a  communicable  disease 
in  other  ways,  and  perhaps  more  frequently,  than  by  heredi- 
tary transmission.     I  remain,  sir, 

Yours  very  respectfully,        O.  H.  C.  O'Brien. 
Mr.  Harold  C.  Ernst,  Harvard  Medical  School. 

115. 

Spencer,  Mass.,  February  15,  1890. 
Dear  Sir,  —  I  have  never  seen  a  case  of  tuberculosis  which 
I  could  trace  directly  to  a  milk  supply  as  a  cause. 

Yours,  E.  W.  Norwood. 

A  note  of  thanks  was  sent  to  Dr.  O'Brien  for  his  letter 
(114),  and  a  request  for  any  cases  of  suspicion  on  the  part  of 
Dr.  Norwood  received  no  reply. 

116. 

Have  never  seen  a  case  where  the  connection  was  at  all 
clear.     In  some  cases  have  had  strong  suspicions. 

Very  truly,  J.  C.  D.  Pigeon. 

RoxBURY,  February  8,  1890. 

A  letter  asking  for  information  in  regard  to  the  cases 
where  milk  was  suspected  as  a  cause  of  tuberculosis  received 
no  reply. 

117. 

Philadelphia,  February  10,  1890. 

Dear  Sir,  —  No,  but  I  do  not  feel  that  I  have  paid  suffi- 
ciently close  attention  to  this  question  in  all  cases  under  my 
observation  to  render  my  negative  report  of  any  statistical 
value.  Yours  truly,  W.  Pepper. 


INFECTIOUSNESS   OF  MILK.  85 

118. 

Harold  C.  Ernst,  Esq.,  M.  D. 

Dear  Doctor,  —  I  have  never  in  all  my  practice  seen  a 
case  of  tuberculosis  which  I  could  trace  to  a  milk  supply 
from  the  cow  or  goat.     I  have  given  much  consideration  to 
the  subject,  and  have  tried  to  investigate  it. 
Very  resp.  and  truly  yours, 

Wm.  H.  Pancoast,  M.  D. 

1100  Walntjt  St.,  Phila.,  February  9,  1890. 

A  note  of  thanks  was  sent  to  Dr.  Pancoast  in  return  for 
the  above. 

119. 

CmcoPEE,  Mass.,  March  12,  1890. 

Dr.  H.  C.  Ernst. 

In  answer  to  your  question  regarding  tuberculosis,  I  can- 
not say  that  I  have  been  able  to  trace  any  case  to  the  milk. 
For  the  most  part,  in  the  country  here,  our  milk  is  from 
healthy  animals.  Yours  very  truly, 

F.  F.  Parker. 

120. 

Dorchester,  February  8, 1890. 
I  have  seen  many  cases  of  tuberculosis,  but  none,  I  think, 
where  I  could  not  trace  a  family  history  as  a  presumable 
cause  rather  than  any  milk  supply.     StiU  I  have  no  doubt 
that  milk  from  tuberculous  cows  could  be  infectious. 

Eespect.  F.  S.  Parsons,  M.  D. 

120  «. 

Dr.  F.  F.  Patch  (Boston,  Mass.)  writes, "  Nothing  approach- 
ing it." 

121. 

Boston,  February  8,  1890. 

Dear  Doctor,  —  Excuse  me,  I  never  use  a  postal-card. 
I   have  made  many  thousand  microscopal  examinations  of 


86  INFECTIOUSNESS  OP  MILE. 

milk  within  the  last  twenty-five  years.  I  have  had  a  large 
number  of  patients  that  have  had  tuberculosis,  but  have  never 
been  able  to  trace  its  cause  to  a  milk  supply,  although  I  have 
been  looking  for  a  cause.  Yours  truly, 

A.  F.  Pattee. 

122. 

Worcester,  February  11,  1890. 
I  have  never  seen  a  case  of  tuberculosis  which  seemed  to 
have  any  connection  with  milk  supply.     Worcester  cows  are 
all  healthy !  C.  A.  Peabody. 

123. 

Littleton,  Mass.,  February  12,  1890. 
Dear  Sir, —  I  have  never  been  able  to  trace  to  a  milk 
supply  as  a  cause  of  tuberculosis.     The  cows  are  usually 
healthy  and  well  fed,  —  hence  good  milk.    We  have  but  little 
tuberculosis  in  this  town.  Yours  truly, 

R.  H.  Phelps. 

124. 

Dr.  H.  C.  Ernst. 

Dear  Sir,  —  I  cannot  state  positively  that  I  have  ever 
seen  a  case  of  tuberculosis  which  could  be  traced  to  a  milk 
supply  as  a  cause,  with  absolute  certainty. 

Very  truly  yours,  R.  B.  Prescott,  M.  D. 

Nashua,  N.  H.,  February  8,  1890. 

125. 
A  note  asking  for  further  information  from  Dr.  Prescott 
was  answered  as  follows  :  — 

Nashua,  N.  H.,  February,  1890. 
Dear   Doctor,  —  The  cases  I  had  in  mind  when  I  an- 
swered your  circular  letter,  occurred  some  fifteen  or  twenty 
years  ago,  when  I  was  in  general  practice  in  New  York  city, 
and  were  dispensary  cases.     But  it  was  so  long  ago,  that  the 


INFECTIOUSNESS   OF  MILK.  87 

evidence,  facts,  and  details  are  wholly  gone  from  mind,  and  I 
am  unable  to  recall  anything  which  would  be  of  service  to 
you  at  the  present  time,  which  for  your  sake  I  very  much 
regret.  Very  truly  yours,  R.  B.  Pkescott. 

A  note  of  thanks  was  sent  for  the  above. 

126. 

Baltimobb,  611  No.  Calvert  St.,  February  10,  1890. 

Dear  Doctor,  —  I  have  no  personal  knowledge  of  any  case 
of  tuberculosis  which  was  traceable  to  infected  milk. 

Very  truly  yours,  Geo.  H.  Eohe. 

Dr.  H.  C.  Ernst. 

A  letter  to  Dr.  Eohe,  asking  if  he  had  information  of  any 
suspected  cases,  received  the  following  reply  :  — 

127. 

Baltimore,  611  No.  Calvert  St.,  February  17,  1890. 

My  dear  Doctor,  —  Dr.  Wray,  the  state  veterinarian  of 
Maryland,  whose  office  is  in  this  city,  spoke  a  few  days  ago 
of  a  family  owning  a  number  of  cows,  a  large  proportion  of 
which  were  tuberculous.  The  family  were  likewise  tubercu- 
lar. He  was  not  ready  to  say  that  there  was  any  connec- 
tion between  the  tubercular  herd  and  the  consumptive  family. 
Possibly  more  detailed  information,  which  he  would  doubtless 
be  glad  to  give,  would  enable  you  to  decide  whether  this 
instance  is  of  any  use  to  you.  Should  I  get  on  the  track  of 
any  cases  likely  to  be  of  any  interest  to  you,  I  will  bear  it  in 
mind  and  will  write  to  you  about  them. 

Very  truly  yours,  Geo.  H.  Rohe. 

Dr.  Harold  C.  Ernst. 

Neither  a  circular  letter  sent  to  Dr.  Wray  personally,  nor 
an  appeal  to  Dr.  Rohe  to  ask  about  the  cases  spoken  of  above, 
met  with  any  response. 


88  INTECTIOUSNESS  OF  MILK. 

128. 

N.  Y.,  37  W.  35th  St.,  February  8,  1890. 

Dear  Doctor,  —  It  is  difficult  to  answer  your  question 
categorically.  I  have  certainly  suspected  at  times  that  the 
milk  supply  was  one  of  the  causes  of  tuberculosis.  I  never 
have  been  able  to  satisfy  myself  that  it,  by  itself,  was  the 
efficient  cause.  Yet  I  can  well  understand  that  it  may  be. 
Yours,  Beverly  Robinson. 

A  letter  was  sent  to  Dr.  Eobinson  asking  for  any  cases  in 
which  he  had  suspected  milk  as  a  cause  of  tuberculosis,  and 
the  following  reply  was  received :  — 

129. 

New  Tokk,  37  W.  35th  St.,  Febniary  22, 1890. 

Dear  Doctor,  —  I  am  afraid  I  cannot  reply  to  your  ques- 
tion in  any  such  way  as  to  be  satisfactory,  or  of  any  real 
value.  I  have  no  recorded  histories,  or  any  positive  facts  to 
relate. 

I  have  merely  remarked  that  children  have  lost  flesh  and 
strength  at  times,  without  assignable  cause,  and  with  a  very 
clear  hereditary  history.  In  such  instances  when  the  parents 
were  closely  questioned,  I  have  found  occasionally  that  the 
children  were  fed  almost  exclusively  on  milk.  Now,  when 
the  source  of  the  milk  supply  was  inquired  into,  it  was  dis- 
covered that  it  was  from  a  locality  where  I  had  reason  to 
suspect  that  there  was  little  or  no  intelligent  supervision  of 
the  cattle,  and  where  from  the  poverty  of  the  peoj)le  and 
their  bad  hygienic  surroundings  I  premised  that  there  might 
be  tuberculous  cattle  in  the  herds. 

You  perceive  at  once  that  this  statement  offers  little  to  a 
scientific  inquirer  in  the  way  of  real  acquisition.  It  is,  how- 
ever, the  best  I  can  send  you.  I  feel  like  adding  that  I 
regret  my  postal,  as  it  may  have  given  rise  to  some  misappre- 
hension in  regard  to  the  sum  of  my  knowledge.  It  is  now 
my  practice,  however,  in  cases  of  bottle-fed  infants,  to  use 


INFECTIOUSNESS   OF  MILK.  89 

every  possible  precaution  in  regard  to  the  cow  or  cows  who 
furnish  the  milk  supply  to  the  child.  I  consider  auscultation 
of  the  lungs  of  the  cow  by  a  well  informed  veterinary  to  be 
one  of  the  best  means  at  our  command,  of  detecting  tubercu- 
lar disease  in  its  incipient  stage.  If  this  examination  be 
positive  as  to  its  revelations,  I  shall  hereafter  direct  that 
another  cow  be  called  upon  to  furnish  the  milk,  and  the 
diseased  cow  be  isolated  or  gotten  rid  of  altogether.  At  a 
more  advanced  stage  of  tuberculous  disease  in  the  cow,  and 
always  as  an  additional  test,  I  believe  expert  examination  of 
the  milk,  in  view  of  your  researches,  should  be  insisted  on,  to 
recognize,  if  possible,  the  presence  of  the  bacillus  tuberculosis. 
Sincerely  yours,  Beverly  Kobinson. 

A  note  of  thanks  was  sent  to  Dr.  Eobinson. 

130. 

Chattanooga,  Tekn.,  February  6,  1890. 
Dear  Doctor,  —  There  are  so  many  chances  for  error  in 
the  search  you  are  making  for  proof  that  tuberculosis  may  be 
communicated  through  a  milk  supply,  that,  notwithstanding 
the  full  warrant  for  perfect  faith  in  this  factor,  I  fear  you 
will  not  be  able  to  find  a  case  that  will  stand  the  severe  test 
that  must  be  given  in  the  interest  of  medical  truth ;  I  mean, 
to  exclude  every  other  cause  or  carrier  which  might  be  pres- 
ent in  the  nursery,  in  the  household,  in  the  schoolroom,  in 
the  street,  in  the  workshop,  factory,  church,  theatre,  etc.,  etc. ; 
indeed,  in  a  hundred  other  ways  through  which  the  b.  tuber- 
culosis may  be  carried  and  find  lodgment  in  the  human  body. 
I  have  just  completed  examinations  of  tissues  from  two  cows 
—  the  material,  lungs,  mammary  glands  and  sputum  having 
been  sent  to  me  for  that  purpose  from  Michigan  —  in  which 
tyjjical  specimens  of  bacilli  of  tubercidosis  were  present. 
I  shall  look  for  the  result  of  your  proposed  task  with  much 
interest.  Very  truly  yours, 

Jas.  E.  Reeves. 


90  INFECTIOUSNESS  OF  MILK. 

A  note  of  thanks  was  sent  to  Dr.  Reeves  for  this  communi- 
cation. 

131. 

No,  although  I  believe  strongly  in  the  transmission  of 
tuberculosis  by  milk,  yet  I  have  never  seen  a  case  in  which  I 
could  trace  the  disease  directly  to  that  cause. 

P.  G.  Robinson,  St.  Louis. 

131a. 

Boston  Citt  Hospital,  February  15, 1890. 
Dr.  H.  C.  Ernst,  Harvard  Medical  School. 

Dear  Doctor,  —  In  reply  to  your  circular  letter,  I  would 
say  that  after  inquiry  amongst  several  of  our  more  recent 
house  officers,  and  also  among  the  "\asiting  staff,  I  cannot  find 
that  we  have  ever  had  a  case  of  tuberculosis  here  which  it 
seemed  possible  to  trace  to  a  milk  supply  as  a  cause. 
Yours  very  truly, 

G.  H.  M.  RowE,  Superintendent. 

A  note  of  thanks  was  sent  to  Dr.  Rowe  for  his  note  and 
the  trouble  he  had  taken. 

132. 

No.  28  East  38th  Street,  New  York, 
February  11,  1890. 

My  dear  Dr.  Ernst, — I  have  your  question  regarding 
tuberculosis  and  milk  supply.  In  reply  I  wish  to  say  that  I 
have  never  been  able  to  trace  a  case  of  tuberculosis  to  this 
source.  On  the  other  hand,  I  have  seen  many  cases  when  I 
could  not  in  any  way  trace  the  cause  of  disease,  and  I  await 
your  conclusions  with  much  interest. 

Yours  truly,  Newton  M.  Shaffer. 

Thanks  were  sent  to  Dr.  Shaffer  for  his  note. 


INFECTIOUSNESS   OF  MILK.  91 

133. 

February  10, 1890. 

Pear  Doctor,  —  Have  had  no  case  of  either  phthisis 
pulmonalis,  or  tuberculosis,  which  I  could  have  traced  to  milk 
as  a  cause  (that  is,  bovine  milk). 

Yours,  etc.,  E.  L.  Shurley. 

A  note  was  sent  to  Dr.  Shurley  asking  for  information  in 
regard  to  any  cases  of  transmission  of  tuberculosis  by  milk 
other  than  bovine  which  he  might  have  seen,  with  the  follow- 
ing reply :  — 

134. 

25  Washington  Avenue,  Detroit,  Mich. 

Dr.  Harold  C.  Ernst. 

Dear  Sir,  —  I  have  seen  two  cases  of  miliary  tuberculosis 
which  I  thought  due  to  mothers'  milk,  but  do  not  remember 
any  due  to  the  milk  of  other  animals. 
Yours  sincerely, 

E.  L.  Shurley, 

(per  S.  E.  S.) 

135. 
A  request  for  fuller  details  of  the  cases  mentioned  by  Dr. 
Shurley  received  the  following  reply :  — 

25  Washington  Aventje,  Detroit,  Mich., 
February  25,  1890. 

H.  C.  Ernst,  M.  D. 

My  dear  Doctor,  —  In  regard  to  your  request  for  the 
notice  or  observation  of  miliary  tuberculosis  by  mothers'  milk, 
I  would  say  that  I  shall  have  to  look  up  the  cases  in  my  note- 
book, and  will  do  so  as  soon  as  I  can,  unless  you  are  content 
with  the  fact  that  two  children  of  healthy  parentage,  suffer- 
ing from  miliary  tuberculosis,  came  imder  my  observation, 
and  who  were  nursed  by  tuberculous  nurses.     I  will  not  enter 


92  INFECTIOUSNESS   OF  MILK. 

into  details  unless  you  desire  it,  because  in  a  month  or  two 
you  will  see  some  papers  that  will  be  published  in  the  "  Amer- 
ican Journal  of  Medical  Sciences  "  by  Professor  Gibbes  and 
myself  on  the  subject  of  tuberculosis  and  phthisis  pulmonalis, 
in  wliich  I  wiU  appear  as  one  who  believes  that  miliary  tuber- 
culosis is  not  phthisis  pulmonalis.  Should  you  desire  the 
details  of  the  cases  I  will  endeavor  to  look  them  up. 

Yours  truly,  E.  L.  Shurley. 

A  note  was  sent  to  Dr.  Shurley  asking  for  fuller  details  of 
the  cases,  at  the  same  time  suggesting  that  these  might  be 
some  of  the  cases,  details  of  which  had  already  been  refused 
by  Dr.  Gibbes  (see  his  letters),  and  that  therefore  Dr.  Shur- 
ley might  desire  to  reconsider  his  decision  to  send  the  fuller 
details.     This  note  was  answered  as  follows :  — 

136. 
Harper  Hospital,  Detroit,  Mich.,  March  1, 1890. 
My  dear  Doctor,  —  Yom-  letter  of  the  29th  is  at  hand. 
In  reply  would  say  that  I  am  greatly  interested  in  your  work, 
and  am  ready  to  lend  whatever  aid  I  am  able  to ;  but  of 
course  must  for  the  present  accede  to  the  desire  of  Dr.  Gibbes 
—  if  he  has  any  —  in  this  matter,  because  he  has  been  for  the 
past  two  years  working  with  me  upon  this  subject.  I  have 
no  doubt  he  will  assent  to  my  giving  you  such  details  as  I 
have  of  the  cases  in  question.  I  will  consult  him  about  it, 
and  write  you  again.  Concerning  the  vexed  question  of  the 
nature  of  tuberculosis,  which  you  incidentally  mention  in  your 
letter,  of  course  we  cannot  very  well  discuss  it  here.  Suffice 
it  to  say  that  I  too  think  that  with  a  proper  understanding 
we  may  not  differ  very  much  in  our  opinions. 

Yours  sincerely,  E.  L.  Shurley. 

A  note  of  thanks  was  returned  to  Dr.  Shurley  for  this 
letter,  but  nothing  has  been  heard  from  him  in  regard  to 
fuller  reports  of  the  cases. 


INFECTIOUSNESS  OF  MILK.  93 

137. 

I  have  seen  a  number  of  cases  of  intestinal  tuberculosis  in 
children  fed  on  cow's  milk,  in  which  other  causes  could  be 
safely  excluded.  N.  Senn. 

A  letter  of  inquiry  to  Dr.  Senn  asking  for  fuller  details 
of  these  cases  met  with  no  response. 

138. 

3733  VmcENNEs  Avenue,  Chicago, 
Febraary  14,  1890. 

My  dear  Doctoe  Ernst,  —  In  reply  to  your  inquiry  I 
would  say  that  I  have  never  seen  a  case  of  tuberculosis  which 
I  could  possibly  trace  to  impure  milk.     Theoretically  I  can- 
not accept  such  a  cause  of  the  disease  possible. 
Yours  sincerely, 

Edward  Warren  Sawyer. 

139. 

I  have  never  traced  the  cause  of  tuberculosis  to  milk  sup- 
ply in  any  case.  I  have  seen  infants  nursed  by  mothers  suf- 
fering from  pulmonary  tuberculosis  without  their  (the  infants) 
showing  any  immediate  effects  in  the  form  of  tuberculosis. 

Dr.  Skene,  Brooklyn. 

A  letter  to  Dr.  Skene  asking  for  details  of  the  cases  spoken 
of  by  him  failed  to  receive  a  response. 

140. 

Philadelphia,  February  10, 1890. 
My  dear  Doctor,  —  I  have  not  been  able  so  far  to  get  a 
dear  indication  that  milk  acted  as  a  cause  in  any  of  my  cases 
of  tuberculosis.     I  will  continue  to  watch  closely  and  report 
to  you  any  point  in  that  direction  that  I  may  meet  with. 

Sincerely  yours,  Chas.  E.  Sajous. 


94  INFECTIOUSNESS   OF  MILK. 

A  note  to  Dr.  Sajous  asking  for  any  suspicious  cases  that 
he  might  have,  received  the  following  reply :  — 

141. 

1632  Chestnttt  Street,  Philadelphia, 
April  22,  1890. 

My  dear  Doctor  Ernst,  —  I  did  not  answer  your  favor 
of  the  14th  of  February,  believing  that  I  might  be  of  some 
little  use  to  you  by  inquiring  as  to  the  milk  question  among 
the  patients  (few  in  number)  in  my  hands.  So  far  nothing 
worth  noting,  negatively  or  positively,  in  any  of  them,  has 
come  up,  the  difficulty  arising  principally  from  their  igno- 
rance as  to  the  source  of  their  milk,  etc. 

Sincerely  yours,  Sajous. 

A  letter  of  thanks  was  sent  to  Dr.  Sajous  for  his  trouble. 

142. 

Kansas  City,  Mo.,  February  13, 1890. 
Dear  Sir,  —  Have  never  seen  a  case  of  tuberculosis  that  I 
could  certainly  trace  to  a  milk  supply  as  a  cause. 

E.  W.  Schauffler. 

A  note  asking  if  Dr.  Schauffler  had  had  any  cases  in  which 
he  had  suspected  milk  as  a  cause  received  no  reply. 

143. 

Buffalo,  N.  Y.,  February  18, 1890. 

My  dear  Doctor,  —  Such  cases  I  have  suspected,  but  I 
do  not  feel  like  stating  that  I  have  seen  one. 

Yours  very  truly, 

Chas.  G.  Stockton. 


INFECTIOUSNESS   OF  MILK.  95 

144, 

Lawrence,  February  14,  1890. 

Hakold  C.  Ernst,  M.  D. 

Dear  Sir,  —  I  am  greatly  interested  in  the  subject  of  your 
circular,  and  have  paid  considerable  attention  to  it.  I  could 
not  trace  any  case  of  tuberculosis  to  milk  supply,  but  I  have 
seen  cases  of  tuberculosis  in  cows  in  the  surroimding  country 
which  I  feel  sure  would  give  rise  to  tuberculosis  in  a  fit  sub- 
ject drinking  such  milk. 

Sincerely  yours, 

Andrew  F.  Shea,  M.  D. 

145. 

WiLLiAMSTOWN,  Mass.,  February  10,  1890. 
Dear  Sir,  —  In   reply  to  your  inquiry  must  answer  no. 
The  question,  you  know,  is  one  that  has  only  a  very  recent 
basis  on  which  to  ask  it.  Yours  truly, 

K.  M.  Smith. 

146. 
Suppose  one  person  in  a  hundred  uses  the  milk  of  tubercu- 
lous cows,  and  that  one  sixth  of  all  persons  die  of  tuberculosis  ; 
one  in  six  hundred  die  using  that  kind  of  milk ;  now  I  should 
think  it  extremely  hazardous  to  trace  the  certain  relations  of 
cause  and  effect  m  an^/ case  whatever.  I  know  nothing  about 
the  effect  of  our  digestive  processes  as  destructive  or  preserv- 
ative of  bacillus  or  any  such  organism  whatever. 

Dr.  John  Spare,  New  Bedford. 

146  a. 

No ;  the  breast  milk  probably  has  nothing  to  do  with  these 
cases  of  hereditary  notions. 

W.  E.  Sparrow, 

Mattapoisett,  Mass. 

February  7,  1890. 


96  INFECTIOUSNESS  OP  MILK. 

147. 

I  like  your  question  because  I  cannot  answer  it.  I  am 
disgusted  with  most  of  the  milk  I  find  among  my  patients.  I 
am  very  glad  indeed  you  have  in  this  manner  called  my  at- 
tention to  the  milk  supply  question.  I  hope  to  hear  from 
you  again.     I  will  study  this  subject. 

Yours  cordially,  Geo.  E.  Stackpole. 

148. 

I  cannot  now  recall  a  case  of  tuberculosis  in  my  own  prac- 
tice directly  traceable  to  milk  supply. 

Jas.  Carey  Thomas. 

28  Madison  Avenue,  Baltimobe. 

A  letter  asking  for  any  cases  that  Dr.  Thomas  had  heard 
of  met  with  no  reply. 

149. 

Dear  Doctor,  —  I  believe  I  know  of  no  case  where  I  con- 
sider the  connection  directly  traced. 

James  K.  Thacher, 

New  Haven. 

A  letter  asking  Dr.  Thacher  for  an  account  of  any  cases 
where  the  suspicion  had  been  aroused  in  his  mind  received  no 
reply. 

150. 

Dear  Doctor,  —  I  can  recall  no  case  of  phthisis  which  I 
could  attribute  to  the  use  of  milk  from  tuberculous  cows.  It 
would  be  hard  to  do  so,  because  most  of  my  patients  receive 
their  milk  from  out-of-town  dealers,  the  condition  of  whose 
cows  is  imkno\vn  to  me.  Very  tridy  yours, 

H.   C.  TOWLE. 
July  10, 1890. 


INFECTIOUSNESS   OF  MILK.  97 

151. 

No;  our  cattle  in  this  vicinity  are  remarkably  free  from 
disease. 

G.   J.    TOWNSEND, 

South  Natick,  Mass. 
152. 

SuNDEBiiAND,  Mass.,  February  13, 1890. 

Dr.  H.  C.  Eenst. 

Dear  Sir,  —  I  have  never  seen  a  case  of  tuberculosis  which 
I  could  trace  to  the  milk  supply.  Your  inquiry  leads  me  to 
say  that  I  have  often  wondered  whether  the  common  barn- 
yard fowl  ever  communicates  this  disease.  It  is  usually 
well  cooked,  to  be  sure.  It  is,  however,  the  filthiest  feeder  of 
any  food  animal  in  common  use  amongst  us,  —  human  excre- 
ment, the  sputa  of  phthisical  persons,  and  the  like  vile  foods 
being  apparently  as  palatable  to  the  ordinary  hen  as  the 
choicest  viands,  while  the  opportunity  of  picking  up  such 
foods  are  ample  and  usually  made  the  best  of. 

Yours  truly, 

C.  G.  Trow. 

153. 

Dear  Dr.  Ernst,  —  I  never  have  been  able  to  trace  a 
case  of  tuberculosis  to  lacteal  origin ;  but  then,  I  have  never 
tried.  I  am  glad  that  you  are  looking  the  matter  up,  but 
fear  that  the  time  is  premature.  Yours, 

T.  G.  Thomas. 

A  letter  was  sent  to  Dr.  Thomas  asking  why  he  thought 
the  "  time  premature  "  ?     He  replied  as  foUows :  — 

154. 

600  Madison  Avenue,  New  York. 

My  dear  Doctor,  —  What  I  meant  was  this,  —  that  the 
subject  is  yet  so  young  that  time  has  not  been  afforded  for 


98  INFECTIOUSNESS  OF  MILK. 

testing  the  validity  of  the  theory  advanced.  I  am  glad  that 
you  have  entered  upon  the  inquiry,  for  the  question  is  one  of 
the  most  important  that  could  come  up  for  investigation. 

Sincerely  yours, 

T.  Gaillard  Thomas. 

A  note  of  thanks  was  sent  to  Dr.  Thomas  for  his  note. 

155. 

Cincinnati,  February  21, 1890, 100  W.  8th  St. 

Dear  Doctor  Ernst,  —  I  have  had  cases,  one  or  two, 
children,  of  basilar  meningitis  secondary  to  intestinal  affec- 
tions and  independent  of  bronchial  catarrh,  in  new  houses, 
parents  and  attendants  unaffected,  brought  up  on  the  bottle, 
which  I  could  interpret  in  no  other  way,  especially  as  the 
milk  used  was  from  one  cow  only.  Yours  truly, 

J.  T.  Whittaker. 

A  note  was  sent  to  Dr.  Whittaker,  asking  if  any  of  the 
cows  from  which  the  milk  spoken  of  in  the  above  note  were 
proven  to  be  affected  with  tuberculosis,  with  the  following 
reply :  — 

156. 

Cincinnati,  February  28, 1890. 
My  dear  Doctor,  —  The  cows  in  both  cases  were  appar- 
ently healthy.  No  examination  was  made  of  the  milk.  I 
mentioned  the  cases  because  I  could  find  no  other  explanation 
for  origin.  The  houses  were  new,  the  parents  and  attendants 
free  from  all  signs  of  the  disease,  and  the  surroundings 
(rural)  perfectly  good.  The  disease  had  not  existed  in  even 
remote  ancestry.  I  say  this  for  the  benefit  of  believers  in 
heredity,  of  which  I  am  not  one.  But  the  milk  was  taken 
from  one  cow  in  each  case,  and  intestinal  catarrh  was  the  f ore- 
rimner  of  the  meningitis.  Sincerely  yours, 

J.  T.  Whittaker. 


INFECTIOUSNESS   OF  MILK.  99 

A  note  of  thanks  was  sent  to  Dr.  Whittaker  for  the  above 

note. 

157. 

1413  Washington  St.,  Boston,  February  11,  '90. 

My  dear  Sir,  —  In  reply  to  your  circular,  —  my  field  of 

observation  has  been  a  very  large  one.     I  would  not  assert 

that  milk  was   the   direct  cause  in  the  adult  consumptive 

(tuberculous).     It  may  be  quite  different  with  children.     I 

might  add  that  the  query  is  in  its  infancy,  and  difficult  to 

solve  for  the  present.  P.  D.  Walsh. 

158. 
Dear  Sir,  —  I  do  not  think  of  any  case  of  tuberculosis 
that  I  could  trace  to  milk  supply  as  a  cause.  I  have  no  doubt 
but  tuberculosis  in  man  may  come  from  the  consumption  of 
milk  from  diseased  cows.  The  sale  of  beef,  such  as  I  have 
seen,  should  be  punished  with  death. 

Yours  truly,  K.  C.  Ward,  M.  D. 

NOKTHFiEiiD,  Mass.,  February  8,  1890. 

159. 

Dear  Doctor,  —  Please  excuse  my  delay  in  answering 
your  circular,  which  has  been  almost  forgotten,  because  I 
have  no  statistics  to  offer.  I  have  not  seen  a  case  of  tubercu- 
losis which  I  could  trace  to  a  milk  supply,  but  I  think  that 
the  public  should  be  protected  against  the  use  of  the  milk  or 
the  flesh  of  tuberculous  animals. 

Yours  truly,  J.  R.  Webster. 

17  Dec  St.,  Dobchesteb,  February  24, 1890. 

160. 

No,  never  except  maternal. 

Robert  White,  M.  D. 

The  following  note  was  sent  to  Dr.  White  :  — 


100  INFECTIOUSNESS   OF  MILK. 

161. 

Boston,  March  15, 1890. 

My  dear  Sir,  —  In  the  reply  that  you  sent  me  to  my 
query  in  regard  to  the  transmission  of  tuberculosis  by  milk, 
you  say  "  never  except  maternal."  Will  you  be  kind  enough 
to  give  me  some  account  of  any  such  cases  that  you  have,  the 
fuller  the  notes  that  you  will  send  me  the  better  ?  Of  course 
names  are  not  necessary.  It  will  be  a  great  help  to  me,  if 
you  can  see  your  way  to  doing  what  I  ask. 

Very  truly  yours,  Harold  C.  Ernst. 

Dr.  Robert  Whitb,  Boston,  Mass. 

The  following  was  Dr.  White's  reply :  — 

162. 
Boston,  March  17,  1890,  331  Hanover  St. 

Dr.  Ernst. 

Dear  Sir,  —  The  expression  "  never  except  maternal " 
means  that  like  produces  like.  Very  truly  yours, 

Egbert  White,  M.  D. 

Dr.  White's  reply  was  so  little  courteous  that  no  answer 
was  returned  to  it. 

163. 

PoMEEOT,  Iowa,  Febrnary  11,  1890. 
Having  always  had  a  country  practice,  where  as  a  rule  milk 
is  pure  and  plentiful,  I  have  never  seen  a  case  of  tuberculosis 
which  seemed  traceable  to  a  milk  supply  as  a  cause. 

Yours,  etc.,  D.  W.  Wight. 

164. 
Dear  Doctor,  —  I  think  I  have  seen  many  such,  for  ex- 
ample, tubercular  disease  from  milk,  mostly  in  hand-fed 
babies  of  perfectly  healthy  parentage,  developing  tabes  mes- 
enterica,  phthisis,  tubercular  meningitis,  yet  I  cannot  prove 
it  scientifically  in  a  single  case. 

Edw.  T.  Williams,  M.  D. 

EoxBURY,  February  8,  1890. 


mrECTIOUSNESS  OF  MILK.  101 

An  appeal  to  Dr.  Williams  for  any  details  he  could  give 
me  received  the  following  reply  :  — 

165. 

KoxBUBY,  February  13,  1890. 

Dear  Doctor  Ernst,  —  Have  you  ever  seen  a  monograph 
by  a  Dr.  Klenke,  of  Leipsic,  "  Ueber  die  ansteekung  und 
verbreitung  der  serofel-krankheit  bei  menschen  durch  den 
genuss  der  kuh-milch,"  16mo,  Leipsic,  1846?  It  is  cited 
by  West,  "Diseases  of  Infancy,"  London,  5th  ed.,  1865, 
page  504,  near  the  end  of  his  last  chapter  on  phthisis,  with 
some  brief  but  judicious  observations  of  his  own  on  the  same 
point.  This  subject  of  tuberculous  infection  from  milk  has 
been  in  the  air  for  fifty  years  at  least.  A  vast  deal  has  been 
talked  and  written  about  it.  My  own  attention  was  very 
early  called  to  it,  and  has  been  one  of  the  motives  of  my  long 
efforts  to  establish  a  diet  kitchen  in  Roxbury,  for  the  distribu- 
tion of  pure  milk  for  sick  children,  and  to  help  establish  the 
Seashore  Home,  without  thanks  or  profit  to  myself,  but  I 
think  with  substantial  benefit  to  the  community.  I  know 
that  diseased  milk  breeds  tuberculosis,  but  when  you  ask  for 
details  of  cases,  I  am  at  a  loss  to  give  them.  Details  escape 
the  memory,  but  leave  behind  impressions,  and  often  convic- 
tions. My  note-books  are  not  indexed,  and  those  of  the  Sea- 
shore Home  inaccessible  ;  besides,  my  cases  have  been  among 
the  very  poor  and  migrating  sort  of  people,  where  it  is  diffi- 
cult to  get  a  complete  family  history,  and  you  must  eliminate 
heredity,  or  your  case  goes  for  nought.  .  .  .  My  interest  in 
abdominal  tuberculosis  was  first  excited  by  the  unrivaled 
description  of  that  disease  in  its  enteric,  mesenteric  and  peri- 
toneal forms,  by  Rilliet  and  Barthez.  There  is  no  work  in 
any  other  language,  that  I  know  of,  that  contains  even  a 
decent  account  of  the  disease.  They  show  clearly  that  the 
old  "  tabes  mesenterica,"  though  illy  named  and  described,  is 
not  a  myth,  but  a  reality.     And  my  impression  is  formed  on 


102  INFECTIOUSNESS   OF  MILK. 

clinical,  but  not  post-mortem^  experience,  that  it  is  there,  in 
the  intestine  and  mesenteric  glands,  that  we  shall  have  to 
look  for  the  earliest  manifestations  of  tuberculosis  from  in- 
fected milk  or  cream.  I  am  very  sorry  I  can't  aid  you  further, 
and  wish  you  every  success  in  your  inestimably  useful  investi- 
gation. Yours  sincerely, 

Edw.  T.  Williams. 

A  note  of  thanks  was  sent  to  Dr.  Williams  for  his  letter. 

167. 

Harold  C.  Ernst,  M.  D. 

My  dear  Sir,  —  Your  note  of  inquiry  is  at  hand.  The . 
subject  is  of  great  importance  and  of  especial  interest  to  me, 
for,  in  consequence  of  tuberculosis,  all  extra  pulmonary  at 
first,  I  have  instituted  the  very  inquiry  you  suggest.  While 
my  suspicion  was  first  directed  to  milk,  then  to  food  in  gen- 
eral, I  must  retire  without  a  single  incident  upon  which  to 
base  a  fact.  I  hope  you  will  obtain  something  reliable.  My 
difficulty  has  been  with  the  general  statements  of  the  patients ; 
in  fact,  after  discovering  that  none  of  them  have  been  large 
milk-drinkers,  I  conclude  it  would  prove  nothing  if  they  were, 
for  one  drop  of  tubercularized  milk  would  do  the  infection  if 
subjective  conditions  were  right.  Of  course  we  have  facts 
concerning  the  possibility  of  producing  general  tuberculosis 
in  animals.  I  believe  that  milk  is  a  convenient  vehicle,  and 
the  most  probable  one  for  human  infection.  Investigations 
into  the  sudden  sicknesses  of  healthy  infants,  pointing  to 
gastro-enteric  irritation  with  subjective  cerebral  symptoms, 
would  seem  to  me  to  be  the  field  most  likely  to  lead  to  posi- 
tive results.  ...  I  await  with  great  interest  the  result  of 
your  labors.  Yours  very  truly, 

Hebbeet  F.  Williams. 

Brookltn,  N.  T. 


mPECTIOUSNESS  OF  MILK.  103 

168. 

225  Maklboro'  Street,  February  8, 1890. 
My  dear  Doctor,  —  I  have  never  seen  a  case  of  tuber- 
culosis which  I  thought  was  caused  by  milk,  although  it  is  my 
custom  to  inquire  upon  this  point.     Very  truly  yours, 

Harold  Williams. 

Although  receiving  many  more  affirmative  answers  to  the 
circular  from  veterinarians  than  from  physicians,  the  corre- 
spondence was  hardly  as  satisfactory.  The  letters  that  were 
thought  proper  to  preserve  for  any  reason  are  given  below  in 
alphabetical  order. 

169. 

Dr.  Bland  (Waterbury,  Conn.)  speaks  of  a  case  occurring 
in  his  own  family,  —  he  having  lost  one  of  his  own  children 
with  a  suspected  milk  as  the  origin  of  the  disease. 

He  was,  however,  imable,  upon  appeal,  to  trace  the  milk 
supplied  to  his  family  to  a  tuberculous  cow,  for  the  reason 
that  his  dealer  furnished  mixed  milk.  A  portion  of  his 
letter  follows :  — 

Wateebubt,  CoNir.,  March  22, 1890. 

Harold  C.  Ernst. 

Dear  Sir,  —  It  seems  that  the  milk-dealer  who  supplied 
my  family  does  not  produce  from  his  own  cows  one  fifth  of 
the  milk  that  he  sells,  but  buys  of  other  farmers.  A  few 
years  ago  there  was  a  case  of  tuberculosis  in  a  cow  belonging 
to  a  farmer  living  about  half  a  mile  from  this  milk-dealer, 
and  that  is  the  only  case  that  I  have  known  in  that  neigh- 
borhood. And  that  was  two  or  three  years  before  I  lost  my 
child.  Very  truly  yours, 

Thomas  Bland. 


104  INFECTIOUSNESS   OF   MILK. 

170. 

26  SuDBUBY  Street,  February  12, 1890. 

Dr.  Ernst,  Boston. 

Dear  Sir,  —  In  my  practice  I  do  not  get  an  opportunity 
often  to  observe  the  effect  of  milk  from  diseased  cows,  and 
so  cannot  recall  a  case  to  the  point.  Last  week  I  examined 
a  cow  that  died  from  tubercular  mammitis,  and  that  had 
been  milked  till  within  a  week  or  so  of  death.  If,  as  is 
generally  believed,  tuberculosis  is  contagious,  then  milk  from 
such  an  udder  must  be  particularly  liable  to  transmit  it. 
Yours  very  truly, 

J.  Williamson  Bryden. 

171. 
Dr.  Ernst. 

Dear  Sir,  —  I  don't  know  just  how  I  worded  my  note  in 
answer  to  yoiu*  query  as  to  tuberculosis.  What  I  meant  to 
say  was  that  I  have  known  cases  of  cows  that  I  believed 
were  suffering  from  tuberculosis  whose  milk  was  distributed 
with  other  milk  for  family  use,  and  that  the  deaths  of  chil- 
dren were  frequently  recorded  as  resulting  from  tuberculosis, 
making  it  possible  that  there  was  a  relation  between  them 
and  the  milk  supply.  I  have  no  data  connecting  any  partic- 
ular case  with  the  milk  supply  from  such  cows.  I  have  not 
kept  my  notes  complete  enough,  were  it  possible  to  do  so.  I 
can  give  dates  as  to  the  cows,  but  not  as  to  the  children.  A 
cow  with  tuberculosis,  especially  mammary,  soon  drops  out, 
and  passes  from  our  observation  and  knowledge,  —  they  are 
not  apt  to  last  long  anywhere. 

Yours  respectfully, 

O.  H.  Flagg,  V.  S. 

New  Bedfobd,  February  25, 1890. 


INFECTIOUSNESS  OF  MILK.  105 

172. 

262  Olive  Stkebt,  St.  Louis,  Mo.,  March  8, 1890. 

Harold  C.  Ernst,  Esq. 

Dear  Sir,  — ...  I  believe  tliat  tuberculosis  in  cattle  is 
a  decided  menace  to  the  public  health,  —  especially  when 
there  exist  tubercular  masses  in  the  udder.  .  .  . 

Yours  respectfully,  H.  F.  James. 

173. 

Mr.  Ernst. 

Dear  Sir,  —  ...  In  regard  to  your  first  question,  —  as 
to  whether  I  have  known  the  disease  transmitted  from  ani- 
mals to  the  human  subject,  I  cannot  speak  with  any  authority. 
As  a  matter  of  opinion  my  convictions  are  that  it  not  only 
may,  but  that  it  does  take  place.  I  have  known  several 
cases  of  fatal  "  infantile  diarrhoea,"  and  one  case  of  what  the 
doctors  called  tubercles  on  the  brain,  occurring  in  a  district 
where  the  disease  was  common  among  cows.  These  cases 
are  culled  from  memory,  and  except  in  the  case  of  tubercle 
of  the  brain  I  cannot  say  much  definite  about  them.  The 
latter,  however,  I  do  mind  more  about.  He  was  a  boy,  five 
or  six  years  old,  —  the  son  of  a  landed  proprietor  close  to 
my  native  place.  His  father  was  much  interested  in  rearing 
fine  horses  and  besides  kept  a  herd  of  standard  grade  of 
Ayrshire  cows.  I  do  not  know  that  any  of  them  were 
diseased,  but  they  were  fine-bred  and  in  a  district  where 
tuberculosis  was  common. 

Your  second  question  is  as  to  transmission  from  animal  to 
animal.  By  the  milk,  I  have  not  looked  sufficiently  close  to 
speak  with  certainty.  Have  frequently  had  cases  in  young 
calves  commencing  with  apparently  ordinary  diarrhoea,  but 
which  by  and  by  became  of  a  dysenteric  nature  and  proved 
fatal  in  spite  of  remedial  measures.  These  have  occurred  on 
places  where  tuberculosis  existed,  and  in  my  own  mind  were 
set  down  as  being  tubercular  enteritis.  That  animals  do  take 
it  by  ingestion  of  substances  other  than  milk  I  am  absolutely 


106  INFECTIOUSNESS   OF  MILK. 

certain,  from  the  fact  that  I  have  several  times  seen  cases  in 
older  animals  where  there  were  bowel,  mesenteric,  and  omen- 
tal lesions,  without  any  pulmonary  trouble  whatever.  Again 
I  have  often  met  with  cases  where  there  were  both  thoracic  and 
abdominal  lesions,  but  the  latter  showed  evidence  of  so  much 
priority  as  to  leave  no  doubt  in  my  mind  that  the  pulmonary 
lesions  were  secondary.  Such  cases,  it  seems  to  me,  must 
have  been  due  to  infection  through  the  alimentary  tract. 
Yours  very  truly, 

Geo.  F.  Kinnell. 

A  note  of  thanks  was  sent  to  Dr.  Kinnell  for  his  letter. 

174. 

BiNGHAMTON,  N.  Y.,  February  9, 1890. 

Dr.  H.  C.  Ernst. 

Dear  Doctor,  —  Your  circular  received,  asking  for  infor- 
mation in  regard  to  the  propagation  of  tuberculosis  from 
milk,  and  I  think  I  can  give  you  the  required  information. 
Was  called  to  see  a  herd  of  registered  Jerseys  that  had  been 
ailing  some  time ;  found  herd  affected  with  tuberculosis,  and 
among  them  were  three  cows  that  had  just  dropped  calves. 
Two  of  the  cows  were  apparently  in  a  healthy  condition  with 
the  exception  of  being  in  an  extremely  emaciated  condition 
and  a  large  glandular  enlargement  of  the  manmia.  These 
calves  remained  in  a  healthy  condition  until  they  were  three 
weeks  old,  when  they  commenced  to  have  diarrhoea  which 
repelled  all  treatment,  and  finally  died,  one  in  four  days  and 
the  other  in  one  week.  Diagnosed  these  as  cases  of  phthisis 
abdominalis.  In  about  one  month  the  cows  began  to  show 
symptoms  of  pulmonary  trouble,  and  upon  post-mortem  found 
well-marked  cases  of  phthisis  pulmonalis,  and  the  glandular 
enlargement  was  undoubtedly  of  a  tubercular  nature,  but 
could  not  be  certain,  as  I  was  situated  so  that  a  microscopical 
examination  could  not  be  made ;  but  they  having  well-marked 
symptoms  in  the  lungs  should  make  it  safe  to  assert  that  it 


INFECTIOUSNESS  OF  MILK.  107 

was  a  tubercular  deposit  and  caused  the  death  of  the  calves. 
The  other  calf  died  of  the  same  trouble  in  about  three  weeks, 
but  the  mother  had  no  lesions  in  the  mammary  gland  that 
could  be  discovered,  but  had  large  tubercular  deposits  in  the 
mesentery  and  also  in  the  lungs.  If  these  cases  will  be  of 
any  value  to  you,  I  shall  feel  amply  repaid,  and  if  I  can  be 
of  any  service  to  you  in  the  future  I  will  be  pleased  to  do  it. 
Yours  truly,  G.  A.  Lathrop,  V.  S. 

175. 

New  York,  February  15,  1890. 
Dear  Sir,  —  My  positive  transmission  of  tuberculosis  has 
been  experimental,  having  fed  two  rabbits  and  two  guinea- 
pigs  with  such  material,  and  developing  tuberculosis  ;  I  have 
met  in  my  practice  here  and  there  cases  of  transmission  from 
cow  to  calf,  fed  with  tuberculous  material.  The  cases  of  sus- 
picion of  the  transmission  from  animals  to  man  can  be  ob- 
tained more  from  Dr.  C.  Peabody,^  a  veterinary  practitioner 
of  Providence,  R.  I.  Yours, 

A.   LlAUTARD. 

176. 

W.  D.  Middleton,  V.  S.,  sent  a  very  interesting  account  of 
two  children  fed  on  the  milk  of  tuberculous  cows,  both  dying 
in  from  seven  to  nine  months  after  the  beginning  of  such 
feeding.     His  letter  is  too  long  for  reproduction  here. 

177. 

Columbia,  Mo.,  February  13, 1890. 

Harold  C.  Ernst,  M.  D.,  Boston,  Mass. 

Dear  Sir,  —  Replying  to  yours  of  January,  have  to  say 
that  I  have  seen  three  cases  of  tuberculosis  in  human  beings 
that  seemed  to  have  originated  in  cows'  milk.  I  have  posi- 
tively induced  tuberculosis  in  animals  in  five  or  six  cases  by 

^  See  letter  from  Dr.  Peabody  {infra,  178). 


108  INFECTIOUSNESS   OF  MILK. 

feeding  or  inoculating  milk  from  cows  having  tuberculosis  in 
the  udder.  Yours  very  respectfully, 

P.  Paquin, 

State  Veterinarian. 

A  request  for  further  details  in  regard  to  these  cases  met 
with  no  response. 

178. 

Providence,  R.  L,  March  23, 1889. 

Friend  Peters. 

My  dear  Sir,  —  Yours  of  the  21st  received.  I  have  not 
the  dates  of  the  case  I  reported,  for  at  that  time  I  was  laughed 
at  by  many  of  the  medical  profession  here,  and  I  cannot  now 
recall  where  I  put  the  report  of  it,  but  I  will  give  it  you  as 
near  as  I  can  remember.  ...  I  have  found  my  note-book ;  it 

says :  "  June  15, 1878,  —  Mr.  W called  me  to  see  a  white 

and  red  cow,  Ayrshire  breed.  Coughs,  and  is  short  of  breath 
and  wheezes.  Pidse  60 ;  respiration  14,  and  heavy  at  the 
flanks ;  temperature  104.  Diminished  resonance  of  right 
lung,  but  increased  in  part  of  the  same.  Emphysematous 
crackling  over  left  lung,  and  dullness  on  percussion.  Diag- 
nosed a  case  of  tuberculosis,  and  advised  the  destruction  of 
the  animal.  December  12,  —  Cow  in  a  cold  rain  a  few  days 
ago  for  about  two  hours.  Milk  still  more  diminished  than  at 
a  visit  made  on  September  25.  Again  advised  the  destruc- 
tion of  the  cow.  Family  still  using  the  milk.  Respiration 
20;  pulse  85;  temperature  104.6.  February  22,  1879,— 
Temperature  104.8  ;  respiration  26  ;  pulse  68.  Losing  flesh 
fast.  Milk  still  in  small  quantities.  Advised  as  before  to 
destroy  the  animal,  and  not  to  use  the  milk.  May  30, — 
Called  in  a  hurry  to  see  the  cow.  Is  now  as  poor  as  could 
be.  No  milk  for  a  week.  Pulse  80  ;  respiration  40  ;  temper- 
ature 106.  The  cow  died  in  about  three  hours.  Autopsy 
made  fourteen  hours  after  death ;  limgs  infiltrated  with 
tuberculous  deposit.     Weight  of  thoracic  viscera  43.5  lbs. 


INFECTIOUSNESS  OF  MILK.  109 

Tuberculous  deposits  found  in  the  mediastinum,  in  the  mus- 
cular tissues,  and  in  the  mesentery,  spleen,  kidneys,  udder, 
intestines,  pleura,  and  one  deposit  on  the  tongue.  The  inside 
of  the  trachea  was  covered  with  small  tubercles. 

In  August,  1879,  the  baby  was  taken  sick,  and  died  in 
about  seven  weeks.  On  post-mortem  of  the  child  there  was 
found  meningeal  tuberculosis  deposits  all  over  the  coverings  of 
the  brain,  and  some  in  the  lung.  In  1881,  a  child  about 
three  years  old  died  with,  as  it  was  called,  tuberculous  bron- 
chitis ;  and  in  1886,  a  boy  nine  years  old,  who  for  three  or 
four  years  had  been  delicate,  died  with  consumption,  "  quick," 
as  it  was  called. 

So  far  as  known,  the  family  on  both  sides  had  never  before 
had  any  trouble  of  the  kind,  and  the  parents  were  both  rug- 
ged and  healthy  people,  and  so  were  the  grandparents,  one 
now  being  alive  and  68  years  old,  and  the  other  dead  at  78. 

Yours  ever  truly, 

C.  H.  Peabody. 

The  above  letter  was  sent  to  Dr.  Peters,  and  by  him  incor- 
porated in  this  report. 

179. 

Littleton,  Mass.,  February  19, 1890. 

Dr.  H.  C.  Ernst. 

Dear  Sir,  —  I  am  in  receipt  of  a  letter  from  Dr.  A. 
Worcester,  Waltham,  Mass.,  in  which  he  wishes  me  to  cor- 
respond further  with  you  upon  tuberculosis.  The  Doctor 
cites  a  case  I  told  him  of,  but  his  memory  is  somewhat  at 
variance  with  the  facts.  Tuberculosis  I  undoubtedly  found 
in  the  barn,  and  have  every  reason  to  believe  it  was  trans- 
mitted to  the  house,  although  I  have  not  the  facts  to  prove  it. 
In  the  circular  you  sent  me,  the  question  —  I  took  it  —  re- 
garded the  transmission  of  the  disease  to  the  human  subject. 
If  you  mean  transmitted  to  the  bovines,  I  have  proof  suiBBcient 
to  show  that  in  one  case,  at  least,  I  can  prove  it  does  so  transmit. 


110  INFECTIOUSNESS   OF  MILK. 

If,  as  I  said  on  my  postal,  the  tubercular  deposits  in  the  mam- 
mary glands  are  sufficiently  developed,  I  can  see  no  reason 
why  the  disease  should  not  be  transmitted.  If  I  can  be  of 
any  further  use  to  you  on  this  subject,  do  not  fail  to  call 
upon  me  freely,  for  I  am  delighted  to  be  a  co-worker  with 
you  in  this  important  subject. 

Yours  very  respectfully, 

Alvord  H.  Eose. 

Writing  to  Dr.  Rose  for  further  information  in  regard  to 
the  case  of  which  he  speaks  in  the  above  letter,  he  was  good 
enough  to  send  the  following :  — 

180. 

Littleton,  Mass.,  February  22,  1890. 

Dr.  H.  C.  Ernst. 

Dear  Sir,  —  Your  letter  of  the  20th  inst.  is  at  hand.  In 
reply  I  would  beg  to  state  that  the  case  in  question,  of  which 
I  told  Dr.  Worcester,  was  indeed  a  suspicious  case.  In 
1884  I  was  requested  to  examine  a  herd  of  Jersey  cattle  for 
contagious  pleuro-pneumonia,  in  place  of  which  I  foimd  tuber- 
culosis. We  had  proof  of  the  correctness  of  my  diagnosis  in 
the  post-mortem  examinations  made.  When  I  had  finished 
explaining  the  effect  that  milk  from  a  tuberculous  cow  would 
have  upon  a  caK  drinking  it,  they  said  the  symptoms  were 
identical  with  those  presented  by  their  grandchild  the  summer 
previous.  This  child  had  lived  upon  the  milk  of  a  cow  that 
was  known  to  have  had  tuberculosis  for  three  years.  Was 
this  not  a  suspicious  case?  Let  me  give  you  a  case  near 
the  point.  Three  years  ago  I  visited  a  cow  that  had  tubei*- 
culosis ;  she  was  filling  the  position  of  foster  mother  to  an 
apparently  healthy  calf ;  she  supplied  milk  to  this  calf  for 
about  80  days,  when  the  calf  died  from  exhaustion,  the  residt 
of  obstinate  diarrhoea.  Post-mortem  revealed  the  presence  of 
tubercles  in  the  mesentery,  miliary  tubercles  on  the  costal- 
pleura,  and  two   quite  large   tubercles  in   the  inter-lobular 


INFECTIOUSNESS   OF  MILK.  Ill 

tissue  of  the  right  lung.  The  mother  of  this  calf  died  during 
parturition,  and  was  said  to  have  been  a  perfectly  healthy 
cow,  so  we  cannot  say  tuberculosis  arose  congenitally  in  this 
calf,  but  I  think  it  a  clear  case  of  transmission  of  tubercu- 
losis through  the  medium  of  the  milk.  There  are  several 
more  cases  I  have  seen  that  bear  upon  this  question,  but  were 
I  to  give  them  they  would  be  superfluous.  Gerlach  and 
others  have  produced  tuberculosis  by  ingestion^  in  such  ani- 
mals as  the  pig,  rabbit,  monkey,  chicken,  and  sometimes  the 
dog.  There  is  no  question  but  that  tuberculosis  is  the  result 
of  the  presence  of  a  specific  bacillus  ;  I  am  equally  as  certain 
that  it  is  transmissible  to  man  through  the  flesh  and  milk  as 
it  is  from  cow  to  cow  through  the  milk.  If  I  can  be  of  any 
further  use  to  you  do  not  fail  to  call  upon  me.  I  am,  sir. 
Yours  very  respectfully, 

Alvord  H.  Rose,  D.  V.  S. 

A  note  of  thanks  was  returned  to  Dr.  Rose  for  the  above 
letter,  and  his  consent  was  obtained  for  using  it  in  any  way 
that  seemed  proper. 

A  study  of  the  preceding  letters  shows  that  from  the  medi- 
cal men  there  came  affirmative  answers  to  the  question  asked 
as  follows,  and  in  these  classes  :  — 

From  mother  to  child,  1  (Doggett,  51  «),  1  (Edwards,  53), 
1  (Flagg,  59),  1  (Galvin,  69  &  70),  1  (Gordon,  74  &  75), 
1  (Kollock,  90  a),  1  (Shurley,  133  to  136),  or  a  total  of  7. 
(This  total  means  the  nimiber  of  gentlemen  giving  affirmative 
answers,  not  the  number  of  cases  they  have  seen.) 

From  cow's  milk  to  child,  1  (Conant,  45),  1  (Deane,  51  c), 
1  (Kite,  91  6),  1  (Gibbes,  61  to  64),  1  (Gage,  65  to  68),  1 
(Hulbert,  85  a),  1  (Lovejoy,  99),  1  (Senn,  137),  1  (Whitta- 
ker,  155  &  156),  1  (WiUiams,  164  &  165),  1  (Bailey,  77  & 
78),  or  a  total  of  11.  • 

From  animal  to  animal,  1  (Coates,  35  &  36) ;  a  total  of 
one,  (1). 


112  INFECTIOUSNESS   OP  MILK. 

Certain  gentlemen  expressed  themselves  as  suspicious  tliat 
they  had  seen  such  cases  as  were  inquired  about,  viz. :  — 

1  (Bartlett,  9),  1  (Best,  13),  1  (Coffin,  44),  1  (Duer,  47),  1 
(Dana,  49-51),  1  (Everett,  56),  1  (HaU,  83),  1  (HuU,  85  6), 
1  (Hawes,  85),  1  (Prescott,  124),  1  (Leonard,  97),  1  (Mac- 
kenzie, 108  &  104),  1  (Macdonald,  105),  1  (O'Brien,  113  & 
114),  1  (Pigeon,  116),  1  (Robinson,  128  &  129),  —  a  total 
of  16. 

Those  expressing  disbelief  in  such  a  source  for  the  trans- 
mission of  the  disease  are,  — 

1  (Dodge,  51  fZ),  1  (Garceau,  71),  1  Hutchinson,  85  c?),  1 
(Hunt,  85  c),  1  (King,  92),  1  (Mitivier,  108),  1  (Patch, 
120  a),  1  (Sawyer,  138),  1  (Sparrow,  146  «),  or  a  total  of  9. 

There  were  a  number  of  gentlemen  who  said  that  they  were 
out  of  practice  or  were  specialists  and  had  not  seen  cases  of 
tuberculosis  for  years,  —  of  these  there  were  15. 

There  were  also  others,  not  counted  on  any  other  list,  say- 
ing that  they  had  given  no  attention  to  the  point  whatever,  or 
had  not  had  it  enter  their  minds ;  of  these  there  were  61. 

Of  those  making  a  simple  negative  reply  there  were  893. 

There  were  received,  then,  of  replies  of  some  kind,  — 


Positive  (mother  to  child). 

8 

(cow's  milk  to  child), 

11 

(suspicious  cases), 

16 

Negative  (disbelief), 

9 

Negative  simply. 

898 

Negative  (out  of  practice). 

15 

Negative  (no  attention). 

61 

Total  of  replies  to  the  letter,  1018 

Percentages  based  upon  such  statistics  as  these  are  of  the 
most  misleading  kind,  and  therefore  no  effort  has  been  made 
to  work  out  all  that  could  be  made  ;  but  it  seems  reasonable 
to  state  one,  —  that  showing  the  percentage  of  medical  men 


INFECTIOUSNESS   OF  MILK.  113 

whose  attention  has  been  attracted  to  cases  such  as  the  circu- 
lar makes  inquiry  in  regard  to.  In  reaching  this,  it  seems 
perfectly  fair  to  deduct  from  the  number  of  those  to  be  con- 
sidered, those  who  are  out  of  practice,  or  who  have  not  paid 
attention  to  the  point.  This  would  leave  therefore  937 
(1013  —  76)  upon  which  to  base  the  percentage.  Counting  all 
the  positive  and  suspicious  cases  together,  there  are  35,  and 
the  percentage  of  those  who  have  seen  cases  in  which  their 
suspicions  have  been  aroused  in  this  direction  is  35  -i-  937,  or 
3.7  — ^jer  cent !  —  a  result  that  is  as  unexpected  as  it  is  sur- 
prising in  its  size,  if  one  takes  into  consideration  the  difficulties 
surrounding  the  question,  and  the  newness  of  the  subject. 

There  are  many  other  interesting  things  to  be  found  by  a 
careful  perusal  of  the  letters.  The  cases  related  by  Dr. 
Munro  (110  &  111)  are  interesting,  although  not  coming 
within  the  exact  scope  of  the  question  asked,  and  it  is  to  be 
said  that  out  of  those  who  returned  negative  answers,  and 
besides  those  already  quoted  in  other  ways,  there  were  thirty 
that  expressed  their  entire  belief  in  the  actual  occurrence  of 
such  a  method  of  transmission  of  the  disease. 

Letters  of  interest  for  various  reasons,  besides  those  specially 
referred  to  above,  may  be  found  in  No.  15,  by  Dr.  Blanchard, 
referring  to  the  decrease  of  the  disease  in  Sherborn ;  in  No. 
25,  being  encouragement  from  Dr.  H.  I.  Bowditch ;  No.  38, 
from  Dr.  Chismire,  referring  to  the  prevalence  of  tuberculo- 
sis in  Alaska ;  No.  52,  from  Dr.  Edes,  voicing  the  difficulties 
of  the  investigation ;  No.  55,  from  Dr.  Page,  giving  interest- 
ing statistics  in  regard  to  the  existence  of  tuberculosis  among 
the  insane  ;  No.  58,  giving  Dr.  Forchheimer's  views  upon  the 
subject ;  Nos.  61  to  64,  showing  Dr.  Gibbes'  views  ;  75  a  and 
6,  giving  Dr.  Hodges'  practice  ;  No.  82,  from  Dr.  Henry  ;  86, 
from  Dr.  Inches,  giving  his  practice  ;  88  and  89,  from  Drs. 
Jenrett  and  Jacobi,  emphasizing  the  difficulties  of  the  query ; 
89  a,  from  Dr.  Kinnicutt ;  93,  of  encouragement  from  Dr. 
Lee ;  118,  from  Dr.  Pancoast,  telling  of  his  efforts  in  the 
same  direction ;  130,  from  Dr.  Reeves,  also  emphasizing  the 


114  INFECTIOUSNESS   OF  MILK. 

difficulties  in  the  way  ;  131  a,  in  which  Dr.  Rowe  tells  of  his 
ill  success  in  trying  to  find  cases  ;  139,  where  Dr.  Skene  gives 
negative  evidence ;  145,  where  Dr.  Smith  emphasizes  the 
newness  of  the  question ;  150,  Dr.  Towle  also  speaks  of  the 
difficulty  of  tracing  the  cause  ;  152,  in  which  Dr.  Trow  sug- 
gests the  common  barn-yard  fowl  as  a  possible  cause  of  the 
disease  ;  153  and  154,  where  Dr.  Thomas  speaks  of  the  new- 
ness of  the  subject ;  157,  where  Dr.  "Walsh  says  the  same 
thing ;  and  167,  in  which  Dr.  Williams  gives  negative  evidence. 

So  much  for  the  correspondence  from  medical  men.  That 
from  the  veterinarians  is  much  more  positive,  but  for  some 
reason  it  was  much  more  difficult  to  obtain  replies  to  letters 
of  inquiry  from  them. 

Of  the  replies  received  there  were,  —  Positive,  1  (Clement, 
no  letter)^  1  (Culbert,  no  letter),  1  (Faville,  no  letter),  1 
(Flagg,  171),  1  (Gardner,  no  letter),  1  (Huidekoper,  no  let- 
ter), 1  (Liautard,  175),  1  (Lathrop,  174),  1  (Middleton, 
176),  1  (Paquin,  177),  1  (Peabody,  178),  1  (Rose,  179  & 
180),  1  (Roberts,  no  letter),  1  (Trumbower,  no  letter),  a 
total  of  14. 

Suspicious,  —  1  (Kinnell,  173),  1  (W.  P.  Mayo,  no  letter), 
1  (Bland,  169),  1  (Butler,  no  letter),  1  (Corlies,  no  letter), 
1  (Howe,  no  letter),  1  (James,  172),  1  (Michener,no  letter), 
1  (Russell,  no  letter),  —  a  total  of  9. 

There  were  sent  in  of  negative  answers  31.  Therefore 
there  were  replies  to  the  following  extent :  — 

Positive,  14 

Suspicious,  9 

Negative,  31 

Total,  54 

This  gives  a  percentage  of  persons  among  the  veterinarians 
who  have  seen  cases  where  they  felt  justified  in  suspecting 
such  an  origin  of  the  disease  as  the  investigation  is  seeking, 
of  23  -f-  54,  or  42.59  plus  per  cent ! 


INFECTIOUSNESS   OP  MILK.  115 

Such  a  percentage  is  startling  in  its  size,  until  one  remem- 
bers the  greater  facilities  that  veterinarians  have  for  observing 
such  cases  and  their  origin,  when  it  does  not  seem  so  much 
out  of  the  way,  —  granting  that  milk  may  be  the  vehicle  for 
the  disease  that  the  experimental  evidence  offered  in  this 
paper  tends  to  show  that  it  is. 

Combining  the  statistics  obtained  from  the  two  sources,  it 
appears  that  there  were  991  answers  received  to  the  circular 
letter  that  should  be  counted,  and  that  among  these  there 
were  58  gentlemen  who  have  seen,  or  suspected,  the  existence 
of  such  cases  as  were  inquired  about,  giving  a  percentage  of 
5.84  plus,  which  seems  to  be  somewhat  remarkable  for  the 
reasons  already  given. 

Letters  of  especial  interest,  some  of  them  having  been 
already  referred  to,  are  170,  from  Dr.  Bryden,  quoting  a  case ; 
178,  by  Dr.  Peabody,  especially. 

As  was  said  in  speaking  of  the  letters  from  the  medical 
men,  not  a  reply  was  received  in  which  any  suspicion  of  an 
expression  occurred  that  could  be  twisted  into  meaning  that 
the  writer  had  seen  or  suspected  such  a  case  as  was  inquired 
about,  but  that  at  once  a  note  requesting  further  information 
was  dispatched.  Many  of  these  remained  unanswered,  but 
the  original  affirmative  reply  or  suggestion  was  retained. 

Finally,  Dr.  Jackson  made  a  special  inquiry  in  regard  to 
tuberculosis  among  the  Jews,  and  Dr.  Peters  one  in  regard 
to  the  prevalence  of  tuberculosis.  The  results  of  these  lines 
of  inquiry  are  given  in  the  two  reports  here  appended. 


116  INFECTIOUSNESS  OF  MILK. 


TUBERCULOSIS  AMONG  JEWS. 

Among  the  replies  received  by  Dr.  Ernst,  in  response  to 
a  circular  sent  out  in  May,  1890,  as  to  the  frequency  of  tuber- 
culosis arising  from  the  use  of  milk  of  tuberculous  animals, 
was  a  letter  from  Dr.  Warriner,  of  Bridgeport,  Conn.,  calling 
attention  to  an  article  in  "  The  Nineteenth  Century "  for 
September,  1889.  The  article  cited,  "  Diseases  caught  from 
Butchers'  Meat,"  is  by  Dr.  Behrend,  of  London.  Dr.  Behr- 
end,  after  reviewing  several  articles  proving  the  identity  of 
bovine  and  human  tuberculosis,  speaks  of  the  longevity  of 
the  Jewish  race,  and  the  comparative  rarity  of  tuberculosis 
among  this  people ;  he  draws  the  conclusion  that  the  com- 
parative rarity  of  tuberculosis  in  Jews  may  be  explained,  in 
part  at  least,  by  the  inspection  of  all  meat  eaten  by  the  Jews. 
After  speaking  of  the  hygienic  laws  of  Moses  in  regard  to 
the  selection  of  meat  for  food.  Dr.  Behrend  says  [Quotation, 
p.  418]  :  "  Finally  the  question  ...  in  the  members  of  that 
faith." 

Dr.  Behrend's  experience  is  similar  to  my  own  as  Dispen- 
sary Physician  at  the  North  End  of  Boston. 

I  have  made  a  careful  review  of  all  the  cases  of  tuber- 
culosis seen  during  my  service  as  district  physician.  To  my 
own  cases  I  have  added  the  cases  seen  by  my  predecessor  and 
successor  in  this  office,  for  several  months,  thereby  obtaining 
statistics  of  this  portion  of  the  city  for  three  years.  The 
district  includes  Salem  and  all  adjoining  streets,  and  there- 
fore takes  in  quite  a  large  proportion  of  the  poorer  classes 
of  the  Boston  Jews.  Each  case  is  entered  but  once  on  the 
books. 

During  three  years,  the  following  6ases  applied  for  treat- 
ment :  — 

5,937  Gentiles,  1  Jew  =  5.1  Gentiles. 

1,162  Jews. 


INFECTIOUSNESS   OF  MILK.  117 

Cases  of  tuberculosis :  196  Gentiles,  14  Jews. 

That  is  to  say,  among  Gentiles,  1  case  tuberculosis  in  30.3. 
Among  Jews,  1  case  tuberculosis  in  83,  or  tuberculosis  was 
almost  three  times  as  frequent  among  Gentiles  as  among 
Jews. 

At  the  same  time,  I  would  add  that  during  these  three 
years  not  a  single  case  was  entered,  in  1,162  Jewish  patients, 
of  any  disease  directly  or  remotely  dependent  upon  the  abuse 
of  alcoholic  liquor. 

Stalland,  in  a  book  on  "  London  Pauperism,"  says:  "Jewish 
children  have  no  hereditary  syphilis,  and  scarcely  any  scrof- 
ula." Casper  Glatter  writes  [1864]  :  "  Jews  present  re- 
markable immunity  from  intermittent  fevers,  convulsions, 
tabes  mesenterica  (abdominal  tuberculosis),  and  from  phleg- 
masiae  of  the  respiratory  organs." 

Jews  attain  a  greater  age  than  Gentiles,  as  proved  by  sta- 
tistics throughout  the  world.  In  Prussia,  in  1849,  deaths 
were  as  follows  :  — 

Evangelists  ....     1  in  34.35  inhabitants. 

Catholics 1  in  30.18  " 

Jews 1  in  40.69  " 

Stalland  gives  the  average  life  of  Gentiles  as  87  years ; 
Jews,  49  years. 

Statistics  presented  by  Glatter  to  the  Academy  of  Hungary, 
in  1856,  give  the  average  age  of 

Croats 20.2  years. 

Germans 26         " 

Jews 46         " 

I  have  been  unable  to  find  any  data  as  to  the  causes  of 
death  in  Jews,  but  as  tuberculosis  causes  so  large  a  propor- 
tion of  all  deaths,  in  some  crowded  cities  one  fourth,  or  even 
more,  of  total  deaths,  it  is  reasonable  to  presume  that  a  cer- 
tain immunity  from  tuberculosis  may  be  reasonably  claimed 
as  the  cause  of  a  part  of  the  increased  longevity  of  the  Jews. 
Dr.  Behrend,  quoting  from  a  paper  by  Dr.  Noel  Gueneau  de 


118  INFECTIOUSNESS   OF  MILK. 

Mussy,  "Etude  sur  I'hygiene  de  Moise  et  des  anciens  Israel- 
ites," gives  a  detailed  account  of  the  laws  regulating  the 
choice  of  meat  at  the  slaughter-houses ;  Dr.  de  Mussy  gives 
the  details  on  the  authority  of  the  Grand  Rabbi  of  France. 
[Quotation,  pp.  417,  418.]  "  He  (Moses)  excludes  ...  to 
tuberculous  lesions."  Dr.  Burr,  medical  inspector  at  the 
Brighton  abattoir,  says  the  Jewish  butcher,  often  refuses  a 
large  number  of  cattle,  at  times  one  third.  They  refuse  all 
animals  with  any  external  injury.  In  killing  bullocks,  their 
law  requires  that  the  windpipe  and  half  the  oesophagus  must 
be  severed ;  if  more  than  half  the  oesophagus  is  cut  through, 
the  carcass  is  refused.  In  sheep  and  calves  the  whole  oesoph- 
agus must  be  cut  through. 

If  any  pleuritic  adhesions  are  present  which  are  firmly  at- 
tached to  the  lung,  the  carcass  is  refused. 

To  obtain  some  idea  as  to  the  sort  of  inspection  made  at 
Brighton,  I  wrote  to  the  Rev.  Solomon  Schindler,  asking  him 
several  questions,  which  I  give  with  their  answers.^ 

1st.  What  is  your  personal  experience  as  to  the  prevalence 
of  tuberculosis  among  Jews  ? 

2d.   What  were  the  dietary  laws  of  Moses  ? 

3d.   Are  the  liver  and  other  entrails  eaten? 

4th.  What  is  the  method  of  examination  at  Brighton  ? 

Boston,  October  1,  1890. 

Dr.  Henry  Jackson. 

Dear  Sir,  —  In  answer  to  your  letter  of  September  28, 1 
shall  follow  closely  the  order  of  your  questions. 

1.  My  personal  experience  is  that  consumption  is  as  fre- 
quent among  Hebrews  as  among  other  people.  Why  should 
it  not  ?  The  religious  idea  cannot  prevent  it  or  make  a  dif- 
ference, and  the  dietary  laws  are  hardly  kept  any  longer,  at 
least  not  to  the  extent  as  they  were  formerly  kept,  or  are  still 
kept,  in  Poland  and  Russia. 

2.  The  only  good  that  came  from  the  adherence  to  the 

1  Answer  in  letter. 


INFECTIOUSNESS   OF  MILK.  119 

dietary  laws  was  that  the  post-mortem  inspection  of  the 
animal  proved  whether  it  had  been  in  a  healthy  condition  at 
the  time  of  death.  The  hmgs  were  very  carefully  examined, 
and  any  sign  of  tuberculosis  made  the  whole  carcass  pro- 
hibited meat.  Controversies  arose  frequently  between  the 
authorized  killer  and  examiner  and  the  butcher,  and  tests 
were  made  to  ascertain  the  effect  of  the  tubercle  upon  the 
lung.  If  by  blowing  up  the  lungs  air  would  escape,  the 
animal  was  at  once  condemned. 

3.  Lungs,  liver,  milt,  and  tripe  were  not  only  allowed  to 
be  eaten,  but  were  favorite  dishes. 

4.  The  present  mode  of  examination  is  not  reliable,  and  I 
have  frequently  advocated  inspection  by  the  city  authorities, 
for  the  benefit  of  both  Jew  and  Gentile.  At  present  the 
wholesale  butcher  hires  some  Jewish  cutter,  —  the  class  of 
which  is  fast  dying  out,  —  who  kills  and  inspects  the  animal. 
He  is  paid  by  the  piece,  and  receives  an  income  only  from 
what  he  declares  perfect.  The  temptation  lies  near  that  he 
will  close  his  eyes  to  many  things.  As  a  class,  these  people 
are  poor  and  ignorant.  They  have  merely  learned  the  rules 
prescribed  in  the  Talmud,  and  while  symptoms  may  be  absent 
of  which  they  have  a  knowledge,  the  animal  may  perhaps  be 
an  unhealthy  one. 

Having  declared  a  carcass  fit  for  food,  they  attach  their  seal 
to  it,  and  the  retail  butchers  buy  for  their  Jewish  trade  that 
class  of  meat.  Supposing  the  wholesaler  having  sold  out 
that  kind  of  meat,  and  the  retailer  needing  some,  the  temp- 
tation is  near  to  take  some  other  healthy-looking  piece.  The 
Jewish  public  care  little  about  it ;  they  trust  in  the  butcher. 
The  more  orthodox  classes,  considering  the  eating  of  un- 
allowed meat  a  sin,  believe  that  the  butcher  who  sells  them 
the  meat  will  be  held  responsible  by  God  for  the  sin,  and  the 
liberals  are  too  indifferent  about  it,  and  think  that  all  meat 
that  looks  well  is  healthy,  and  allowed  to  be  eaten. 

I  hope  this  explanation  will  suffice. 

Yours  respectfully,  S.  Schindler. 


120  INFECTIOUSNESS   OF  MILK. 

The  passage  quoted  from  De  Mussy,  and  the  statement 
made  by  the  Rev.  S.  Schindler,  abundantly  prove  that  the 
Mosaic  laws,  if  carried  out  by  a  responsible  person,  even 
though  uneducated,  would,  to  a  great  extent,  exclude  the 
meat  of  tuberculous  animals  from  the  Jewish  markets.  Dr. 
Burr  says  that  tubercidosis  'per  se  is  not  a  sufficient  cause 
for  condemnation  of  the  carcass  by  the  Jewish  butchers. 
Practically  it  is  reasonable  to  suppose  that  the  inspection  in 
our  slaughter-houses  by  Jews  is  a  mere  form. 

Before  drawing  from  such  evidence  any  conclusion  that  the 
immunity  to  tuberculosis  among  Jews  may  be  due  to  any 
care  in  the  selection  of  their  meat,  it  is  necessary  to  consider 
what  evidence  has  been  obtained  that  the  meat  of  tubercidous 
animals  is  infectious.  In  the  first  congress  for  the  study  of 
tuberculosis  at  Paris  in  1888,  one  of  the  questions  brought 
up  for  discussion  was  as  to  the  danger  arising  from  the  use  of 
the  meat  of  tuberculous  animals.  Several  observers  reported 
results  of  experiments  on  animals.  Nocard,  Arloing,  Galtier, 
all  presented  the  results  obtained  from  inoculating  animals 
with  juice  squeezed  from  the  meat  of  tuberculous  animals. 
Nocard  and  Arloing  especially  expressed  the  opinion  that 
though  there  is  danger  in  the  use  of  meat  from  tuberculous 
animals,  the  danger  is  slight.  Nocard's  experiments  show 
that  the  bacilli  of  tuberculosis  do  not  cause  tuberculosis 
when  injected  into  the  blood  current,  and  he  succeeded  in 
causing  tuberculosis  in  animals  only  when  the  inoculations 
were  made  into  the  abdominal  cavity.  [These  explanations 
are  of  much  interest  in  view  of  the  recent  experiments  as  to 
the  antiseptic  properties  of  blood.] 

Nocard  concludes :  — 

"  1.  Meat  of  tuberculous  animals  can  under  certain  circum- 
stances be  dangerous. 

"  2.  But  it  is  very  exceptional  that  it  is  dangerous. 

"  3.  In  such  cases  as  it  is  dangerous  it  is  so  to  a  very  slight 
extent." 

Arloing,  who  made  a  few  experiments,  came  to  the  same 
conclusions  as  Nocard. 


INFECTIOUSNESS   OF  MILK.  121 

Arloing  inoculated  ten  guinea-pigs  with  portions  of  tuber- 
culous organs.     All  became  tuberculous. 

Inoculated  twenty  guinea-pigs  with  juice  of  meat  of  tuber- 
culous animals,  and  two  became  tuberculous.  No  mention  is 
made  as  to  the  extent  of  the  tuberculosis  in  the  animals  used 
for  these  inoculation  experiments. 

M.  Butel,  who  offers  no  experiments  to  sustain  the  opinion 
he  gives,  considered  that  the  meat  of  all  tuberculous  animals 
should  be  destroyed,  no  matter  how  advanced  the  tuberculous 
process  was.  He  says :  "  Tuberculous  meat  and  milk  are  a 
prominent,  and  perhaps  the  chief,  cause  of  consumption  in 
man."     Butel  concludes  :  — 

"  1.  Is  there  danger  in  eating  the  meat  of  tuberculous 
animals  ?  Yes,  it  is  the  unanimous  opinion  of  all  scientists. 
2.  Is  the  danger  great?  It  is  formidable,  both  on  account  of 
the  large  number  of  tuberculous  animals  which  enter  into 
consumption,  and  the  frightful  number  of  persons  that  a  single 
animal  can  infest,  and  finally,  that  each  person  in  turn  be- 
comes an  agent  in  the  spread  of  the  disease." 

Cartier  (inspector  of  abattoirs  in  Paris),  says :  — 

"  1.  Tuberculosis  is  rare  in  calves,  as  attested  by  all  veteri- 
narians, and  yet  this  animal  is  usually  fed  exclusively  on 
milk. 

"  2.  Tuberculosis  is  common  in  adult  cattle,  and  yet  they 
eat  no  meat. 

"3.  Why  is  it  that  in  men  as  in  cattle  tuberculosis  is 
usually  prdmonary  ? 

"  It  seems  to  me  that  if  the  infection  were  frequent  from 
meat  or  milk  the  disease  would  attack  especially  the  organs 
of  the  abdominal  cavity,  particularly  the  digestive  organs." 

After  prolonged  discussion  as  to  the  danger  of  using  the 
meat  of  tuberculous  animals,  the  following  proposition  was 
made  by  Chauveau,  the  president  of  the  congress.  The 
proposition  was  adopted  almost  unanimously,  only  three  vot- 
ing against  it :  — 

"  It  is  proposed  to  follow  out  by  all  means,  including  in- 


122  INFECTIOUSNESS   OF  MILK. 

demnity  to  owners,  the  general  application  of  the  principle  of 
seizing  and  destroying  all  meat  of  tuberculous  animals,  no  mat- 
ter what  the  severity  of  the  lesions  in  the  animals  affected." 
(Congres  pour  I'Etude  de  la  Tub.  chez  I'Homme  et  chez  les 
Animaux.     1^"^^  Session,  1888,  p.  156.) 

In  the  "  Fortschritte  d.  Med."  No.  IV.  1890,  is  a  review  of 
an  inaugural  address  by  Kastner  in  Munich.  Kastner  inocu- 
lated sixteen  guinea-pigs  with  the  juice  of  the  meat  of  twelve 
tuberculous  cows.  Some  of  the  meat  used  came  from  animals 
condemned  on  account  of  generalized  tuberculosis.  The  in- 
oculations were  made  into  the  abdominal  cavity;  none  of  the 
guij;?ea-pigs  were  tuberculous  after  two  months.  In  the  same 
number  of  the  " Fortschritte  "is  an  article  by  Steinheil.  He 
used  for  inoculation  the  juice  of  muscle  taken  from  human 
beings  who  had  died  of  tuberculosis.  Steinheil  inoculated 
fifteen  animals  from  juice  of  tuberculosis,  and  all  the  animals 
became  tuberculous.  Steinheil  judges  that  his  residts  differed 
from  Kastner's  in  that  the  tuberculous  process  in  the  subjects 
used  was  so  advanced,  and  hence  draws  the  conclusion  that 
the  meat  of  animals  with  a  very  advanced  form  of  tuberculosis 
might  be  dangerous. 

It  seems  to  the  writer  probable  that  the  positive  results 
obtained  from  the  inoculations  with  meat  of  tuberculous  ani- 
mals are  due  to  the  presence  of  tuberculous  glands  in  the  tissue 
surrounding  the  muscular  fibres,  rather  than  tuberculosis  of 
the  muscular  fibre  themselves,  a  rare  pathological  condition. 
In  advanced  general  tuberculosis  many  glands  throughout  the 
body  are  affected,  and  such  carcasses  are  undoubtedly  dan- 
gerous for  use  as  food. 

As  yet  no  satisfactory  scientific  evidence  has  been  offered 
that  the  meat  of  animals  affected  with  localized  tuberculosis  is 
infectious. 

While  tuberculosis  is  rare  in  muscular  tissue,  it  is  the  rule 
to  find  tuberculous  lesions  in  the  liver  and  other  glands  of 
the  body,  and  that  organ  especially  should  never  be  used  for 
food,  no  matter  what  the  extent  of  the  disease  in  the  animals 


INFECTIOUSNESS   OF  MILK.  123 

slaughtered.  Meat  that  has  been  condemned  should  be  de- 
stroyed, as  the  various  methods  used  to  preserve  meat,  as 
salting,  drying,  smoking,  do  not  destroy  many  bacteria 
which  are  present.  Direct  experiment  has  shown  that  a 
tuberculous  limg  when  salted  was  as  infectious  as  before  it 
was  treated  in  that  way. 

Henby  Jackson. 

November,  1890. 


124  INFECTIOUSNESS  OF  MILK. 

UPON  THE  PREVALENCE  OF  BOVINE  TUBERCULOSIS. 
By  Austin  Peters,  M.  R.  C.  V.  S. 

Admitting  that  tuberculosis  is  due  to  a  specific  germ,  the 
bacillus  of  tuberculosis,  and  that  it  can  be  communicated 
from  one  animal  to  another  of  the  same  or  a  different  species, 
by  means  of  the  expectorations  after  they  become  dry,  or  by 
the  consumption  of  the  flesh  and  milk  or  dairy  products  of 
tuberculous  cattle ;  yet,  in  order  to  appreciate  the  danger  to 
human  beings  from  the  use  of  the  dairy  products  of  tubercu- 
lous cows,  it  is  imjDortant  to  have  some  idea  of  its  prevalence. 

It  is  an  impossibility  to  get  any  statistics  to  show  the  extent 
to  which  this  malady  exists  among  our  bovine  population,  but  I 
think  I  can  show  that  it  is  of  adequate  frequency  to  be  of  very 
great  importance  from  a  sanitary  and  economic  standiDoint. 

Fleming,  in  his  "Manual  of  Veterinary  Sanitary  Science 
and  Police,"  in  speaking  of  the  geographical  distribution  of 
this  disease  among  animals,  says :  "  Tubercular  phthisis,  or 
tuberculosis,  probably  prevails  among  the  domesticated  ani- 
mals over  the  entire  globe,  though  its  frequency  will  depend 
upon  various  external  influences,  as  well  as  the  constitutional 
tendencies  of  different  species  and  breeds.  In  some  coun- 
tries it  is  enzootic  and  very  destructive.  Such  is  the  case  in 
densely  populated  districts  and  in  unhealthy  climates,  or  in 
regions  where  animals  are  improperly  fed  and  housed.  In 
Mexico,  for  instance,  it  is  very  common  and  causes  much 
loss,  —  about  34^  of  the  animals  slaughtered  for  food  being 
found  affected.  In  Europe,  particularly  in  the  cow-sheds  of 
the  larger  towns  and  cities,  it  is  extensively  prevalent ;  and 
in  this  country  (meaning  England)  it  has  long  been  recog- 
nized as  a  common  disorder  among  animals,  but  more  espe- 
cially as  affecting  the  bovine  species."  Walley's  "  Four 
Bovine  Scourges"  considers  contagious  pleuro-pneumonia, 
rinderpest,  foot  and  mouth  disease,  and  tuberculosis,  as  the 
four  great  cattle  plagues  of  the  world. 


INFECTIOUSNESS  OF  MILK.  125 

In  this  country  rinderpest  is  unknown;  foot  and  mouth 
disease  does  not  exist  at  present ;  contagious  pleuro-pneu- 
monia  is  confined  to  a  limited  area  near  New  York  city,  it 
having  been  stamped  out  in  every  other  locality  in  the  United 
States  where  it  has  ever  existed :  so  that,  to-day,  we  can  safely 
say  that  the  only  one  of  the  four  great  bovine  scourges  star- 
ing us  in  the  face,  and  challenging  us  to  combat,  if  we  are 
not  afraid  to  grapple  with  it,  is  tuberculosis. 

In  France  and  Germany  the  regulations  governing  the 
veterinary  inspection  of  abattoirs  are  very  strict,  and  the 
inspections  made  there  are  the  chief  source  of  any  figures 
upon  the  frequency  of  bovine  tuberculosis  to  be  obtained. 

In  1887,  the  French  government  added  tuberculosis  to  the 
list  of  contagious  animal  diseases  for  Algeria,  and  in  1888 
classed  it  with  the  diseases  recognized  by  the  sanitary  law  of 
France.  Consequently,  at  the  present  time,  bovine  tubercu- 
losis is  the  object  of  repressive  sanitary  law  in  France  and 
Algeria. 

In  France,  every  animal  recognized  as  being  tuberculous  is 
isolated  and  sequestrated,  and  it  cannot  be  removed  except  for 
slaughter,  which  is  carried  out  under  the  surveillance  of  a 
sanitary  veterinary  surgeon.  The  consumption  of  the  flesh 
of  tuberculous  animals  is  sometimes  permitted  under  certain 
conditions ;  that  is,  if  the  disease  is  slight  and  localized,  the 
flesh  is  not  considered  dangerous ;  but  if  it  is  extensive  and 
general,  the  carcass  is  condemned  as  unfit  for  human  food. 

In  Germany,  the  practice  is  for  the  inspecting  veterinarian 
at  abattoirs  to  condemn  carcasses  of  cattle  suffering  from 
general  tuberculosis ;  if  the  malady  be  localized,  the  carcass 
is  marked  in  such  a  way  that  the  consumer  knows  the  animal 
was  tuberculous,  and  the  meat  is  sold  at  a  reduced  price,  to 
be  thoroughly  cooked  before  being  eaten. 

Taking  the  statistics  of  the  French  abattoirs  as  a  basis 
for  arriving  at  results,  M.  Arloing,  a  French  veterinarian, 
estimates  that  in  France  among  the  adult  bovine  population, 
five  out  of  every  1000  are  tuberculous.^ 

1  American  Veterinary  Review,  November,  1889. 


126  INFECTIOUSNESS  OF  MILK. 

According  to  the  statistics  of  the  Minister  of  Agriculture, 
there  were  on  the  farms  of  France  on  the  31st  of  December, 
1887,  8,623,441  adult  cattle.  Including  the  cattle  kept  else- 
where than  upon  the  farms  the  number  would  be  about 
9,000,000  as  the  adult  bovine  population  of  France.  Admit- 
ting that  the  proportion  of  tuberculous  is  to  the  healthy  as 
5  to  1000,  we  see  that  the  number  of  tuberculous  animals 
is  at  least  45,000. 

The  mean  value  of  these  animals  being  estimated  at  300 
francs  each  ($60.00),  the  cost  to  the  government  for  stamp- 
ing it  out,  if  done  all  at  once,  would  be  9,000,000  francs 
(11,800,000),  or  6,750,000  francs  (11,350,000),  depending 
upon  whether  they  were  appraised  at  two  thirds  or  one  half 
their  value.  This  is  not  possible,  as  it  would  take  several 
years  to  eradicate  it,  and  the  cost  would  be  distributed  over  a 
considerable  period,  a  little  being  expended  at  a  time. 

At  the  congress  for  the  study  of  tuberculosis  held  in  Paris, 
July,  1888,  the  following  estimates  were  given  as  to  the 
extent  to  which  tuberculosis  prevails  among  cattle  :  — 

In  England,  according  to  Mr.  Cope,  the  proportion  is  from 
If)  to  26^,  depending  upon  the  locality. 

In  Belgium,  the  proportion  of  tuberculous  cows  is  estimated 
by  M,  Van  Hersten  as  4fo. 

In  HoUand,  M.  Thomassen  reports  the  proportion  of  the 
tuberculous  cattle  to  vary  from  8.4  to  10.6  per  1000.  At  the 
abattoir  of  Augsberg,  in  1887,  the  proportion  of  tuberculous 
cattle  was  3.62^,  and  that  of  tuberculous  calves  was  0.013^. 

Some  of  the  German  abattoir  records  ^  give  us  the  follow- 
ing figures :  — 

Trapp  reports  that  among  11,079  cattle  killed  at  Strasburg 
abattoir  in  1880,  220  or  1.9^  were  tuberculous  (this  number 
did  not  include  those  slightly  affected).  For  the  same  year 
Mandel  found  174  or  3.4^  among  5,105  cattle  slaughtered  at 
the  MuLhouse  abattoir,  and  in  1879,  Strobl  and  Magin  re- 
corded 1125  or  2.5fo  of  44,699  slaughtered  at  Munich.     The 

^  Propagation  of  Tuberculosis  by  Lydtin,  Fleming,  and  Van  Hersten. 


INFECTIOUSNESS   OF  UHLK.  127 

1125  tuberculous  cattle  killed  at  Munich  that  year  were  clas- 
sified according  to  age  as  follows :  — 

Cattle  under  one  year  2  or      .2^ 

"     from  one  to  three  years  81  or    l.lfo 

"     from  three  to  six  years  378  or  33.5^ 

"     over  six  years  664  or  59.2^ 

The  1125  tuberculous  cattle  may  also  be  apportioned  in 
the  following  order :  — 

218  or  1.13     fo  of    19,284  bullocks  slaughtered. 
558  or  5.3       fc  of    15,789  cows  slaughtered. 

40  or    .68     fo  of      5,823  bulls  slaughtered. 

28  or    .73     ^  of      3,803  young  steers  &  heifers  slaughtered. 
1  or  0.0006^  of  149,971  calves  slaughtered. 

From  these  figures  we  see  that  the  disease  is  more  common 
in  cows  over  six  years  old  than  any  other  class  of  neat  stock. 
This  is  due  to  the  fact  that,  living  longer,  they  have  a  longer 
time  in  which  to  acquire  the  disease,  that  their  systems  are 
depleted  by  giving  immense  quantities  of  milk,  and  that  their 
hygienic  surroundings  are  generally  bad,  they  being  kept  in 
hot,  badly  ventilated,  crowded,  and  often  dirty  stables,  and  de- 
prived of  the  fresh  air  and  healthful  exercise  accorded  to  other 
cattle.  This  is  practically  the  case  with  the  cows  kept  in  the 
dairies  surrounding  large  towns  and  cities,  and  it  is  among 
them  that  tuberculosis  causes  the  greatest  havoc  and  brings 
the  percentage  up,  while  the  rest  of  the  bovine  population  is 
comparatively  free  from  it. 

The  statistics  of  the  German  abattoirs  could  be  quoted  until 
they  filled  a  large  volume,  but  a  few  suffice  and  more  would 
be  a  mere  repetition  without  adding  to  our  knowledge. 

The  only  American  abattoir  figures  that  I  know  of  are  some 
from  the  Brighton  abattoir.  Last  year  the  Board  of  Health 
appointed  as   inspector   at  the   Brighton   abattoir  a  young 


128  INFECTIOUSNESS   OF  MILK. 

veterinarian,  Dr.  Alexander  Burr,  a  recent  graduate  of  the 
Harvard  Veterinary  School,  regardless  of  the  protests  and 
appeals  of  the  practical  politicians  who  wished  to  have  the 
place,  recently  vacated  by  a  former  butcher,  occupied  by  an 
impecunious  cow  dealer. 

In  a  paper  read  at  a  meeting  of  the  Massachusetts  Vet- 
erinary Association,  in  June,  Dr.  Burr  gives  an  account  of 
his  duties  as  inspector  from  October  1, 1889,  to  April  1, 1890 ; 
below  I  take  the  liberty  of  quoting  his  figures  upon  tubercu- 
losis :  — 

Total  number  of  cows  and  steers  killed  15,506 

Number  of  animals  tuberculous,  28  cows,  1  ox   29 —   .ITjh 
Number  of  cows  (eastern  and  western)  killed  880  —  S.Sfo 
Number  of  cows  (eastern)  810,  tuberculous         28  —  3.6^ 
Number  of  cows  (western)  70,  tuberculous  0  —  0.0^ 

That  is,  29  animals  were  tuberculous  out  of  15,506,  but  one 
was  an  ox,  the  others  were  cows ;  and  these  28  tuberculous 
cows  came  from  around  this  section  of  the  country.  I  give 
the  remainder  of  Dr.  Burr's  paper,  together  with  the  discus- 
sion which  followed  it,  below :  — 

"  Of  the  twenty-nine  cases  discovered,  there  was  not  one 
among  them  but  showed  pulmonary  lesions.  I  do  not  wish 
to  be  imderstood  as  thinking  there  is  no  such  thing  as  local- 
ized tuberculosis  ;  this  has  been  demonstrated  by  inoculation, 
but  from  my  experience  it  would  seem  that  invasion  most 
frequently  takes  place  through  the  respiratory  passages. 

"  Of  course,  we  must  take  into  consideration  that  the  cows 
coming  here  are  generally  thought  to  be  sound,  that  is,  we  do 
not  get  all  the  animals  used  in  the  cheaper  grades  of  beef ; 
thus  it  will  be  seen  that  the  above  statistics  are  not  the  actual 
statistics  of  the  State  ;  still,  I  think,  a  fair  average  of  abattoir 
statistics.  An  acquaintance  with  the  subject  of  inspection,  as 
reported  in  the  current  professional  journals  of  the  day,  will 
convince  any  one,  unprejudiced,  that  we  are  better  off  than 


INFECTIOUSNESS   OF  MILK.  129 

any  European  country  reported.  That  is,  the  percentage  of 
tuberculosis  among  our  animals  is  less  than  in  any  European 
country.  The  number  of  animals  killed  outside  the  abattoir 
can  only  be  a  very  small  number  compared  with  the  other, 
and  it  would  be  unfair  to  think  that  all  such  are  diseased,  or 
even  one  fourth  of  them. 

"  So  far  as  can  be  judged  from  my  short  period  of  in- 
spection, even  among  our  eastern  cattle,  tuberculosis  exists 
to  a  much  less  extent  than  among  animals  in  the  populous 
centres  of  most  European  countries,  and  among  our  western 
bullocks  tuberculosis  has  almost  no  existence  whatever,  and 
this  class  of  animals  represent  two  thirds  of  our  cattle  pop- 
ulation. 

"I  may  add  in  connection  with  the  foregoing,  that  in 
relation  with  the  abattoir  we  have  an  establishment  where 
fertilizers  are  manufactured,  and  dead  animals  of  all  kinds 
are  received,  such  as  horses  and  cattle,  many  of  which  are 
cows ;  these  animals  represent  a  fair  average  of  the  cows  of 
our  neighborhood  ;  having  died,  the  owners  have  seldom  any 
disposition  to  hide  them.  I  have  examined  all  the  cattle 
brought  here  and  so  far  my  record  is  as  follows ;  — 

Received  dead  cows  at  abattoir  from  October  1,  '89, 

tiU  April  1,  '90,  80 

Number  found  with  tuberculous  lesions,  6 

Percentage,  7.5 

"  No  better  opportunity,  it  seems  to  me,  could  be  found  to 
reach  a  fair  average  of  the  extent  to  which  the  disease  prevails 
among  our  animals." 

The  following  discussion  ensued :  — 

Dr.  Howard  stated  that  his  personal  experience  with  cattle 
was  very  limited,  but  hoped  that  Dr.  Burr  was  right  in  his 
small  estimation  of  the  amount  of  bovine  tuberculosis  in  the 
locality  ;  he  was  afraid,  however,  that  it  existed  to  a  greater 
extent  than  the  essayist  judged  it  to,  from  what  some  of  our 


130  INFECTIOUSNESS   OF  MILK. 

other  practitioners  say,  in  whom  he  has  every  reason  to  feel 
confidence. 

Dr.  Winslow's  experience  with  tuberculosis  was  so  limited 
that  he  had  nothing  to  say  about  it. 

Dr.  Peterson  thinks  that  a  good  many  animals  that  are 
tuberculous  are  not  sent  to  the  abattoir ;  doubted  if  fifty  per 
cent  of  the  creatures  with  the  disease  were  sent  to  the  abat- 
toir. He  then  told  of  a  slaughter  house  out  in  the  country, 
not  a  great  way  from  Boston,  which  he  happened  to  visit  one 
day,  and  where  he  saw  "  strange  sights." 

Dr.  Marshall  said  he  thought  there  was  less  tuberculosis 
around  eastern  Massachusetts  than  many  of  our  members 
would  have  us  believe. 

Dr.  Stickney  said  he  had  but  little  cow  practice,  but  he 
had  seen  a  good  deal  of  bovine  tuberculosis.  He  thought 
that  Dr.  Burr's  statistics  were  not  very  valuable  towards 
showing  the  prevalence  of  the  disease  around  here,  as  the  beef 
he  inspects  comes  chiefly  from  the  West.  Dr.  Burr's  statis- 
tics are  only  correct  as  far  as  the  animals  brought  to  the 
Brighton  Abattoir  are  concerned,  but  do  not  prove  a  great 
deal  beyond  that.  It  is  not  to  be  wondered  at  that  tuberculo- 
sis should  exist  in  many  of  our  well-bred  dairy  herds,  as  it 
has  been  carefully  propagated  there  for  years. 

If  Dr.  Burr's  figures  upon  the  prevalence  of  bovine  tuber- 
culosis in  this  locality,  as  based  upon  the  dead  cows  sent  to 
the  fertilizer  manufactory,  are  correct,  7.5  per  cent  of  the 
milch  cows  in  the  suburbs  around  Boston  being  tuberculous 
would  be  a  rather  alarming  state  of  affairs ;  but  when  we 
consider  that  these  figures  simply  apply  to  the  cows  sent  to 
the  abattoir,  the  estimate  is  more  likely  to  be  too  small  than 
too  large.  The  N.  Ward  Company  take  a  great  many  of  the 
dead  cows  in  the  suburbs  ;  the  Muller  Brothers,  at  Cambridge, 
take  many  more.  We  have  no  figures  to  tell  us  as  to  the  con- 
dition of  these  animals  when  taken  to  these  establishments. 
Then  the  dealers  in  cheap  cows  (and  in  fact  more  expensive 
ones  for  that  matter)  who  attend  the  Watertown  and  Brigh- 


INFECTIOUSNESS   OF  MILK.  131 

ton  markets  know  what  a  tuberculous  cow  is,  although  they 
may  not  know  the  disease  as  tuberculosis ;  they  call  such  cows 
"  coughers,"  and  is  it  likely  that  they  are  knowingly  going 
to  sell  a  "  cougher "  to  a  butcher  at  the  abattoir,  or  that 
an  abattoir  butcher  is  going  to  buy  a  "  cougher  "  to  kill  when 
they  know  that  there  is  a  veterinary  inspector  ready  to  con- 
demn the  carcass  as  unfit  for  human  food  ?  No,  the  "  cough- 
ers "  are  going  to  be  sold  to  dealers  in  cheap  beef,  and  bologna 
sausage  manufacturers,  whose  slaughtering  establishments  are 
outside  of  the  jurisdiction  of  the  Boston  Board  of  Health  and 
safe  from  outside  interference. 

In  the  report  of  the  Massachusetts  Cattle  Commissioners 
for  1888,  is  a  special  article  by  Dr.  J.  F.  Winchester,  of 
Lawrence,  then  a  member  of  the  Board,  upon  tuberculosis. 
He  collected  all  the  information  he  could  upon  the  prevalence 
of  tuberculosis  in  different  portions  of  Massachusetts,  by  cor- 
responding with  the  leading  veterinarians  all  over  the  State, 
asking  them  to  report  the  results  of  any  inspections  of  herds 
which  they  made ;  many  responded,  myself  among  the  number. 
Below  I  give  Dr.  Winchester's  results  as  tabulated  by  him ; 
the  first  table  gives  farms  where  the  disease  existed  as  con- 
firmed by  post-mortems  upon  some  of  the  animals,  the  other 
gives  a  list  of  herds  where  the  disease  in  all  probability  ex- 
isted, although  not  confirmed  by  autopsy. 


132 


INFECTIOUSNESS   OF  MILK. 


Herd. 

Bovines  on 
Farm. 

EUled. 

Suspicious. 

Percentage  killed. 

No.    1 

70 

8 

8 

11.42 

2 

2 

2 

— 

100.00 

3 

57 

5 

— 

8.77 

4 

50 

1 

8 

2.00 

5 

12 

1 

3 

8.33 

6 

12 

2 

1 

16.66 

7 

4 

1 

— 

25.00 

8 

90 

12 

78 

13.33 

9 

34 

2 

3 

5.88 

10 

36 

19 

— 

52.91 

11 

32 

32 

— 

100.00 

12 

61 

1 

361 

1.65 

13 

14 

8 

— 

57.14 

14 

5 

2 

3 

40.00 

15 

4 

4 

— 

100.00 

16 

7 

2 

5 

28.57 

17 

30 

4 

2 

13.33 

18 

5 

4 

1 

80.00 

19 

25 

7 

2 

28.01 

20 

35 

6 

— 

17.18 

21 

2 

1 

— 

50.00 

22 

1 

1 

— 

100.00 

23 

1 

1 

— 

100.00 

24 

8 

3 

— 

37.67 

25 

28 

4 

— 

14.28 

26 

30 

4 

— 

13.33 

27 

44 

30 

142 

68.49 

28 

23 

6 

— 

25.84 

29 

17 

6 

— 

29.41 

30 

2 

1 

— 

60.00 

31 

17 

4 

12 

23.52 

32 

48 

6 

3 

12.50 

33 

40 

30 

102 

75.00 

34 

20 

20 

— 

100.00 

866 

243 

189 

28% 

1  Eleven  otherwise  disposed  of. 

2  Disposed  of  otherwise. 


INFECTIOUSNESS   OF  MILK. 


133 


Bovines  on 
Farm. 

Symptoms  of 

Percentage  that  showed 

Herd. 

Disease,  but 

Suspicious. 

Symptoms  of  Disease,  but 

none  killed. 

none  killed. 

No.    1 

24 

2 

8.33 

2 

13 

2 

— 

15.38 

3 

12 

1 

— 

8.33 

4 

8 

— 

— 

— 

5 

38 

1 

2 

2.63 

6 

15 

2 

1 

13.33 

7 

11 

2 

6 

18.18 

8 

7 

— 

— 

— 

9 

30 

2 

3 

6.66 

10 

28 

2 

3 

7.14 

11 

15 

1 

— 

6.66 

12 

11 

2 

2 

18.88 

13 

12 

6 

2 

50.00 

14 

3 

2 

1 

66.00 

15 

17 

3 

4 

17.66 

244 

28 

24 

11+% 

That  is,  in  Massachusetts  during  1887  and  1888,  Dr. 
Winchester  learned  of  34  herds  where  tuberculosis  actually 
existed  as  demonstrated  by  post-mortem  examinations.  The 
34  herds  contained  866  head  of  cattle,  of  which  243  or  28 
per  cent  were  killed  as  tuberculous,  and  189  more  were 
suspicious.  In  the  15  herds  where  tuberculosis  in  all  proba- 
bihty  existed,  but  where  no  post-mortems  were  obtained  to 
prove  it,  there  was  a  total  of  244  head,  of  which  28  head  or 
11+  per  cent  showed  symptoms  of  tuberculosis,  and  24  more 
were  suspicious.  On  the  49  farms  there  is  a  grand  total  of 
1110  head  of  cattle,  of  which  271  are  probably  tuberculous, 
and  213  suspicious.  Of  the  213  suspicious,  some  were  cer- 
tainly tuberculous,  and  a  number  were  disposed  of  in  other 
ways  than  killing,  that  is,  sold  into  other  herds  where  the 
disease  may  not  have  before  existed,  to  act  as  new  foci  of 
infection. 

The  following  table  of  the  cows  owned  by  the  Massachu- 
setts Society  for  Promoting  Agriculture,  at  their  experiment 
farm  at  Mattapan,  from  January  1,  1888,  to  July  1,  1890,  all 
of  them  being  more  or  less  tuberculous,  is  additional  evidence 


134 


INFECTIOUSNESS  OF  MILK. 


of  the  frequency  of  this  disease  in  Massachusetts,  but  one  cow 
being  obtained  outside  of  the  State. 

List  of  cows  owned  by  the  Massachusetts  Society  for  Pro- 
moting Agriculture,  during  experiments  carried  on  at  farm  at 
Mattapan :  — 


Cow. 

Where  from. 

Breed. 

A 

Peabody 

Native 

B 

Milton 

Jersey 

Ci 

D 

Danvers 

Native 

E 

Danvers 

Native 

F 

Danvers 

Grade  Shorthorn 

G 

Danvers 

Native 

H 

Danvers 

Native 

I 

Danvers 

Native 

J 

Peabody 

Grade  Shorthorn 

Ka 

L 

Jamaica  Plain 

Native 

M 

Peabody 

Grade  Guernsey 

N 

Peabody 

Guernsey 

0 

Newport,  R.  I. 

Jersey 

P 

Framingham 

Native 

Q 

Brookline 

Guernsey 

B 

Brookline 

Jersey 

s 

Jamaica  Plain 

Grade  Guernsey 

T 

WeUesley 

Jersey 

U 

Barre 

Grade  Guernsey 

V 

Cambridge 

Native 

W 
Y 

Lynnfield 

Jersey 

Brookline 

Grade  Ayrshire 

It  will  be  seen  by  the  foregoing  table  that  22  tuberculous 
cows  were  used  in  the  work,  coming  from  11  different  towns, 
and  representing  15  different  herds.  Of  these,  nine  were 
natives,  five  Jerseys,  two  grade  Shorthorns,  two  Guernseys, 
three  grade  Guernseys,  and  one  grade  Ayrshire  ;  the  Chan- 
nel Island  cattle  and  their  grades  outnumbering  any  other 
class,  the  so-called  native  coming  next. 

In  order  to  obtain  stiU  further  information  as  to  the  preva- 
lence and  distribution  of  bovine  tuberculosis,  about  350  of  the 

^  Bought  for  another  purpose. 

2  Healthy,  bought  for  another  purpose. 

^  Showed  no  well-marked  evidences  of  disease  on  post-mortem  examination. 


INFECTIOUSNESS  OF  MILK.  185 

following  circulars  were  sent  out  to  veterinarians  in  various 
parts  of  the  United  States  towards  the  end  of  the  summer, 
with  a  blank  to  be  filled  out  and  returned  to  the  sender :  — 

MASSACHtrSETTS  SOCIETY   FOR  PROMOTING  AGRICULTURE, 

23  Court  Street,  Boston,  August  20,  1890. 

Dear  Doctor,  —  I  wish  to  collect  some  statistics  to  show 
the  frequency,  or  infrequency,  of  tuberculosis  among  cattle  in 
various  parts  of  the  country.  If  you  will  fill  out  the  inclosed 
blank  and  return  it  as  soon  after  September  1st  as  conven- 
ient, you  will  confer  a  great  favor. 
Yours  truly, 

Austin  Peters,  M.  E.  C.  V.  S. 

P.  S.  More  blanks  will  be  furnished  on  application. 

Seventy-nine  answers  were  received  to  the  circular,  which 
may  be  classified  as  follows :  — 

Practitioners  in  large  cities,  whose  practice  is  confined  almost 
exclusively  to  horses,  hence  they  could  report  no  cases  of 
bovine  tuberculosis,  21 

Veterinarians  with  a  mixed  practice,  but  had  no  cases  in 
the  specified  time,  19 

Veterinarians  reporting  cases  in  their  practice,  39 

79 

The  following  tables  have  been  prepared  from  the  answers 
of  the  two  latter  classes,  those  whose  practice  is  confined  to 
horses  presenting  nothing  of  special  interest  to  tabulate. 

It  is  preferable  to  number  the  reports,  as  some  of  the  cor- 
respondents wish  their  names  not  to  be  made  public  ;  but  I 
believe  them  to  be  reliable  men,  most  of  them  being  known  to 
me  personally  or  by  reputation. 


136 


INFECTIOUSNESS   OF  MILK. 


ANSWERS  TO  CIRCULARS  SENT  TO  VETERINARIANS,  SEC- 
OND IN  ORDER  ON  CLASSIFIED  LIST. 

ANSWERS     FROM    VETERINARIANS    HAVING    MIXED    PRACTICE,   BUT 
REPORTING  NO  CASES   OF   TUBERCULOSIS. 


Veterina- 
rian. 

Town. 

Reply. 

1 

Roxbury,  Mass. 

No  cases. 

2 

Newton,  Mass. 

No  cases  for  two  years. 

3 

New  Bedford,  Mass. 

No  cases  in  four  and  one  half  years'  practice. 

4 

Fall  River,  Mass. 

No  cases. 

5 

Holyoke,  Mass. 

No  cases.  Thinks  it  decreases  in  Western 
Massachusetts. 

6 

Falmouth,  Mass. 

Has  seen  no  cases  in  a  six  months'  practice. 

7 

Providence,  R.  I. 

Has  seen  no  cases  around  Providence. 

8 

New  Haven,  Conn. 

Has  seen  no  cases  in  a  year's  practice. 

9 

Jersey  City,  N.  J. 

Has  very  little  cattle  practice ;  no  cases  for 
two  years. 

10 

Bethlehem,  Pa. 

Has  never  had  a  case  in  his  practice. 

11 

Pittsburg,  Pa. 

His  practice  is  chiefly  among  horses ;  believes 
it  to  exist  in  cow  stables  about  city,  but 
dairy  inspector  is  an  ignorant  butcher  ap- 
pointed for  political  reasons. 

12 

Charleston,  S.  C. 

Has  seen  no  cases  there. 

13 

Savannah,  Ga. 

Has  never  seen  a  case  in  three  years  in  the 
South. 

14 

Mobile,  Ala. 

Has  had  no  cases  since  1888. 

15 

Rushville,  Ind. 

That  part  of  Indiana  is  almost  exempt. 

16 

Chicago. 

Never  saw  a  case  in  his  Nebraska  experiences. 

17 

Bloomington,  lU. 

Is  rare  in  that  part  of  State. 

18 

St.  Joseph,  Mo. 

Has  seen  none  in  three  and  one  half  years' 
practice. 

19 

St.  Louis,  Mo. 

Is  rare  ;  if  anything,  it  decreases. 

This  table  shows  that  tuberculosis  is  rare  in  certain  locali- 
ties among  cattle,  particularly  at  the  South.  It  would  also 
appear  from  the  two  tables  that  in  New  England  the  mild 
climate  of  what  is  known  as  the  "  South  Shore  "  is  less  favor- 
able for  its  development  than  the  more  rigorous  climate  of 
Maine,  New  Hampshire,  and  Eastern  Massachusetts.  In 
justice  to  Maine  it  must  be  said  that  the  disease  is  kept 
pretty  well  under  there,  the  report  coming  from  the  State 
Veterinarian,  and  representing  the  whole  State  (see  second 
table). 


INFECTIOUSNESS   OF  MILK.  137 

When  reports  come  from  different  portions  of  the  same 
State,  one  giving  cases,  and  another  saying  he  has  none,  it 
helps  to  prove  the  infectious  character  of  the  disease,  showing 
how  it  spreads  in  one  locality,  while  it  does  not  exist  among 
the  cattle  of  another. 


138 


INFECTIOUSNESS   OF  MILK. 


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INFECTIOUSNESS   OF  MILK.  141 

From  this  table  it  will  be  seen  that  in  the  practice  of  39 
veterinarians,  representing  17  States,  most  of  them  reporting 
for  one  year  only,  there  occurred  549  cases  of  tuberculosis, 
242  suspicious  cases,  a  total  of  791,  among  165  herds,  con- 
taining in  round  numbers  about  3000  animals.  That  is,  in 
the  herds  where  tuberculosis  existed,  about  18  per  cent  were 
diseased  and  over  8  per  cent  suspicious,  a  total  of  about  26 
per  cent. 

From  the  foregoing  pages  it  will  be  seen  that  bovine  tuber- 
culosis is  quite  a  common  disease,  particularly  among  the 
dairy  herds  of  the  East,  and  that  the  time  is  not  far  distant 
when  action  must  be  taken  to  prevent  its  spread  among  cattle, 
as  well  as  to  protect  consumers  from  the  use  of  tuberculous 
beef  and  dairy  products. 

I  have  presented,  in  the  preceding  pages,  the  evidence  that 
we  have  been  able  to  collect  upon  the  points  in  regard  to 
which  information  seemed  to  be  especially  needed.  This 
evidence  is  sufficient,  it  appears  to  me,  to  warrant  certain 
definite  conclusions,  as  follows  :  — 

1.  While  the  transmission  of  tuberculosis  by  milk  is  prob- 
ably not  the  most  important  means  by  which  the  disease  in 
propagated,  it  is  something  to  be  guarded  against  most  care- 

fully. 

2.  The  possibility  of  milk  from  tuberculous  udders  contain- 
ing the  infectious  element  is  undeniable. 

3.  With  the  evidence  here  presented,  it  is  equally  undenia- 
ble that  milk  from  diseased  cows  with  no  appreciable  lesion 
of  the  udder  may,  and  not  infrequently  does,  contain  the 
bacillus  of  the  disease. 

4.  Therefore  all  such  milk  should  be  condemned  for  food. 

Respectfully  submitted,  Harold  C.  Ernst. 


PLATE    I. 

Comp.  Oc.  6.  obj.  A. 

Coccidium  Ovifoiine  in  Liver.     Nodules  resemble  tuberculosis. 


v'?^^?^5^4?*^i>^^^'1^?^;^'^'u^  '• 


'.>K' 


PLATE   II. 

Comp.  Oc.  6.  obj.  F. 

The  Same. 


^i- 


«1^ 


PLATE    III. 
KAJiiUT  20,  (Table  X.).     Intestinal  tuberculosis  after  subcutaneous  in- 
oculatioft  ivitli  six  drops  of  jnilk.     Death  in  eight  weeks. 


PLATE    IV. 

Comp.  Oc.  6.  obj.  AA. 

Section  of  one  of  the  miliary  nodules  of  intestine,  from  preceding. 


PLATE   V. 

Comp.  Oc.  6.  obj.  AA. 

Rabbit  27  (Table  III.).    Section  showing  miliary  nodule  forming  about 

vessel  in  lung. 


PLATE   VI. 
Comp.  Oc.  6.  obj.  AA. 
Rabbit  27  (Table  III.).     Liifig,  showing  miliary  nodule  arid  consolida- 
tion near  bronchus. 


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PLATE   VTT. 

Comp.  Oc.  6.  obj.  A. 

Rabbit  53  (Table  III.).     Spleen,     Clieesy  Mass. 


"s^ 


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4 


v^ 


« 


'.'? 


PLATE   VIIT. 

Comp.  Oc.  6.  obj.  AA. 

Rabbit  54  (Table  TIL).     Cheesy  nodule  at  point  of  iiiocjilatio)!. 


fc.V 


PLATE    IX. 
Comp.  Oc.  6.  obj.  AA. 

Pig  10  (Table  V.).     Liver.     Curious  shaped  tuberculous  nodule. 


PLATE   X. 

Comp.  Oc.  6.  obj.  AA. 

Calf  K  (Table  \'I.).     Limg,  Interstitial  Pneitmonia  {non-tuberciilous). 


i-i'^ 


'•^%- 


PLATE   XI. 

Comp.  Oc.  6.  obj.  AA. 

Calk  U  (Table  VI.).     Liver.      Curious  nodicle  of  tuberculosis. 


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PLATE   XII. 

Comp.  Oc.  6.  obj.  AA. 

Calf  B  (Table  VI.).   Luitg.    Tuberculosis  involving  bronchus  and  vessel. 


•j^ 


-•  v>'; 


>n?> 


PLATE   XIII. 

Comp.  Oc.  6.  obj.  AA. 

Calf  B  (Table  VI.).    CoTisolidation  {Tuhejxnlous). 


\ 


PLATE   XTV. 

Comp.  Uc.  6.  obj.  AA. 

Cow  H  (Table  VI I  .)•     Tiil'c'iritloits  nodule  im'olving  bronchus  and  7'esse/. 


\ 


PLATE   XV. 

Comp.  Oc.  6.  obj.  AA. 

Cow  H  CTable  Yll.).      Udder.     Interstitial Mammitts. 


/ 


PLATE   XVI. 

Comp.  Oc.  6.  obj.  AA. 
Cow  F  (Table  VII.).     Udder.     Apparent  Interstitial  Mam7nitis,  really 

tuberculous. 


^0    %■# 


R& 


1 

\ 


i 


PLATE   XVII. 

Comp.  Oc.  6.  obj.  A  A. 

Rabbit  io  (Table  X.).     Ccecum^  Tuberailosis. 


